A clinical comparison between coronally advanced flap with amniotic membrane or subepithelial connective tissue graft in treatment of miller class I and II gingival recessions

Abstract

Amniotic membrance is one of the absorbable allogenic grafts with numerous advantages and nowadays is used in different medical fields especially opthalmology and skin. the aim of this randomized controlled clinical trial was to compare coronally advanced flap with amniotic membrane or subepithelial connective tissue in treatment of miller class I and II gingival recessions. Methods: 30 defects in 11 patients with miller class I and II gingival recessions >= 3 mm depth, were treated with amniotic membrane or subepithelial connective tissue graft. Gingival recessions in the test group were treated with coronally advanced flap and amniotic membrane, and in the control group with coronally advanced flap and subepithelial connective tissue. the studied parameters included width of keratinized tissue, probing depth, clinical attachment level, recession depth and width, percentage of root coverage, position of mucogingival junction(MGJ), plaqe index and gingival index were evaluated at baseline and 1, 3 and 6 months after surgery. All data were analyzed by SPSS, ANOVA and T-tests. Results: all of the patients completed the study. After 6 months, the mean root coverage was 75+-28/26% and 63+-63/40% in control and test group, respectively. Both of the treatment modalities led to improvment in the recession depth and width and clinical attachment level (p<0/01). There was no significant difference in width of keratinized tissue in both treatment groups compared to baseline. There was no significant difference in any of the evaluated parameters between the study group. Conclusion: It does not seem that the application of nmniotic membrane in comparison with subepithelial connective tissue graft improves the clinical results of root coverage procedures, but this modality in comparison with standard procedure (coronally advanced flap with subepithelial connective tissue graft) significantly reduces surgical time and postoperation patient discomfort and it is possible to treat multiple defects simultaneously.