Efficacy of a harvest graft substitute for recession coverage and soft tissue volume augmentation: A randomized controlled trial. Issue 3 (16th August 2021)

• Record Type: Journal Article
• Authors: McGuire, Michael K.; Janakievski, Jim; Scheyer, E. Todd; Velásquez, Diego; Gunsolley, John C.; Heard, Rick H.; Morelli, Thiago
• Is Part Of: Journal of periodontology. Volume 93:Issue 3(2022)
• Page Start: 333
• Page End: 342
• Publication Date: 2021-08-16
• Subjects: collagen; connective tissue; esthetics -- dental; gingival recession; personal satisfaction; Periodontics -- Periodicals; 617.632
• DOI: 10.1002/JPER.21-0131
• Languages: English
• ISSNs: 0022-3492

Abstract

Abstract: Background: The autogenous connective tissue graft (CTG) with coronally advanced flap (CTG+CAF) is the "gold standard" for recession defect coverage; however, researchers continue to pursue lower morbidity, more convenient and unlimited supply harvest graft substitutes, including those that could provide soft tissue volume augmentation. Methods: A randomized, controlled, double‐masked comparison of a volume‐stable collagen matrix (VCMX) versus CTG was conducted at four clinical investigation sites. Single, contralateral, within patient matched‐pair, RT1 recession defects were treated with VCMX+CAF (test) and CTG+CAF (control). The primary efficacy end point was percent root coverage at 6 months. Secondary efficacy end points included clinical measures such as soft tissue volume, attachment level, and keratinized tissue width. Patient‐reported outcomes included measures such as discomfort, esthetics, and overall satisfaction; 6‐month end point results were followed for 1 year. Results: Thirty patients received control and test therapies, and all patients were available for follow‐up measures. Average percent root coverage for CTG+CAF was 90.5% ± 14.87% versus 70.7% ± 28.26% for VCMX+CAF, P <0.0001. Both therapies produced significant soft tissue volume increases (84.8 ± 47.43 mm 3 control versus 48.90 ± 35.58 mm 3 test, P = 0.0006). The test, harvest graft substitute produced less postoperative pain and was preferred by patients at the 6‐month end point. All other end point measures were not significantly different. Conclusions: VCMX+CAF root coverage was inferior to CTG+CAF but produced less morbidity and was preferred by patients. Case/patient selection and surgical technique appear key to achieving successful results with the harvest graft alternative.