Evaluation of acellular matrix vs. connective tissue for gum recessions.
Journal name: Journal of Indian Society of Periodontology
Original article title: A comparative clinical evaluation of acellular dermal matrix allograft and sub-epithelial connective tissue graft for the treatment of multiple gingival recessions
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Somnath B. Koudale, Pretti A. Charde, Manohar L. Bhongade
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: A comparative clinical evaluation of acellular dermal matrix allograft and sub-epithelial connective tissue graft for the treatment of multiple gingival recessions
Year: 2012 | Doi: 10.4103/0972-124X.100921
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Gingival recession presents a significant aesthetic and functional challenge in periodontal therapy, impacting patients' appearance and dentine sensitivity. Various surgical techniques have been developed to achieve root coverage, with the coronally positioned flap being a prevalent choice for treating Miller class I and II recessions. While acellular dermal matrix allograft (ADMA) has emerged as an alternative to the traditional subepithelial connective tissue graft (SCTG), its effectiveness is still a subject of study. This research aimed to evaluate and compare the effectiveness of ADMA and SCTG when used with a coronally positioned flap in the treatment of multiple gingival recessions in aesthetic regions.
ADMA Versus SCTG: A Comparison of Efficacy
The results of the study indicated no significant differences in the reduction of gingival recession between the ADMA and SCTG groups, with mean root coverage observed at 94% and 97%, respectively. Both graft types also showed notable improvements in clinical parameters, including probing pocket depth, clinical attachment level, and width of keratinized tissue. The use of ADMA was particularly advantageous as it eliminated the need for a palatal donor site, resulting in less invasive surgery and reduced postoperative morbidity. The significant findings suggest that both grafting techniques yield favorable outcomes for root coverage, while ADMA offers a promising substitute due to its non-invasive nature.
Conclusion
The findings of this study support the use of ADMA as a viable alternative to SCTG for the treatment of multiple gingival recessions. Both approaches were effective in achieving satisfying root coverage and improving clinical parameters without significant complications. The lack of need for a donor site with ADMA reduces patient discomfort and offers the potential for extensive grafting in a single procedure. Clinical relevance, particularly regarding patient satisfaction for aesthetic corrections, underscores the importance of continued exploration into ADMA's use in periodontal therapy as a promising option for clinicians and patients alike.
FAQ section (important questions/answers):
What is the purpose of this study on ADMA and SCTG?
The study aimed to compare the effectiveness of acellular dermal matrix allograft (ADMA) and subepithelial connective tissue graft (SCTG) combined with coronally positioned flap (CPF) for treating multiple gingival recessions in aesthetic areas.
What are the inclusion criteria for participants in the study?
Participants had to be aged 18-40 years with multiple gingival recession defects classified as Miller's Class I or II, presence of at least 2 mm recession depth, and a width of keratinized gingiva of at least 2 mm.
How were clinical outcomes measured after the procedures?
Clinical outcomes such as probing pocket depth, clinical attachment level, gingival recession, and width of keratinized tissue were recorded at baseline and 6 months post-surgery to evaluate the effectiveness of the treatments.
What were the findings regarding root coverage between ADMA and SCTG?
The study found no significant difference in root coverage between ADMA and SCTG groups, with mean root coverage being 94% for ADMA and 97% for SCTG, indicating both techniques are effective alternatives.
What are the advantages of using ADMA over SCTG?
ADMA eliminates the need for a palatal donor site, resulting in less invasive surgery and reduced post-operative morbidity, while providing sufficient graft material for treating multiple sites simultaneously.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Evaluation of acellular matrix vs. connective tissue for gum recessions.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Atman (Ātman, Ātma, Atma, Ātmā):
Acellular Dermal Matrix Allograft (ADMA) is a popular alternative graft material used in periodontal surgery for root coverage. This graft type is preferred due to its attributes of being a non-immunogenic scaffold that integrates into the host tissue without the need for a donor site, thus reducing postoperative morbidity.
2) Study (Studying):
This clinical study aims to compare the effectiveness of two grafting techniques, ADMA and SCTG, in treating multiple gingival recessions. The study involves assessing parameters like clinical attachment level and width of keratinized tissue, seeking to provide evidence for optimal treatment options in periodontal therapy.
3) Post:
Post-refers to the time frame following surgical procedures where multiple evaluations occur. Postoperative assessments are critical to determine the success of treatments, such as healing outcomes and patient satisfaction. In this study, postoperative results were recorded at 6 months to evaluate the long-term efficacy of the grafts used.
4) Incision:
Incisions are critical surgical cuts made during procedures to enable access to underlying tissues. In this study, horizontal and vertical incisions were performed to create a mucoperiosteal flap for graft placement, contributing to the success of the surgical outcomes and proper coverage of the gingival recessions.
5) Surface:
The term 'surface' generally refers to the exterior layer of tissues, including the tooth root surfaces in this study. Proper surgical techniques in preparing the root surfaces are crucial for achieving successful root coverage and periodontal healing, influencing the graft's integration and functional outcomes.
6) Hygiene (Hygienic):
Oral hygiene is a critical component in periodontal health and recovery, impacting postoperative outcomes. In the study, patients underwent oral hygiene instruction to ensure plaque control, which is vital to prevent complications such as infection and to enhance the healing process after surgical interventions.
7) India:
India serves as the geographic location where the study was conducted. The specific cultural, environmental, and socio-economic factors in India are relevant as they can influence patient behaviors, expectations regarding dental aesthetics, and healthcare access, which ultimately inform the applicability of study findings.
8) Table:
Tables in research provide a concise summary of results and clinical parameters. In this study, tables display comparative data on clinical outcomes between different treatment groups, allowing for easier interpretation of results and facilitating the assessment of the effectiveness of the surgical techniques employed.
9) Dressing:
A dressing is applied post-surgery to protect the surgical site. In this study, periodontal dressings were used to aid healing and minimize discomfort in patients. Using a dressing can also promote better patient outcomes by reducing the risk of irritation and contamination during the recovery period.
10) Bleeding:
Bleeding is a common concern during and after surgical procedures. In this study, monitoring of papillary bleeding index served as an indicator of gingival health. Minimizing bleeding is essential for optimal healing and reflects the surgical site's stability and the patient's overall periodontal wellness.
11) Repopulation:
Repopulation refers to the process by which cells migrate to a damaged area and integrate into the existing tissue. In the context of ADMA, understanding repopulation helps assess how effectively the graft facilitates healing and tissue regeneration, yielding insights into root coverage and aesthetic outcomes post-surgery.
12) Harvesting (Harvest):
Harvesting involves obtaining connective tissue for grafting, primarily from donor sites. In this study, a key advantage of ADMA is that it negates the need for harvesting tissue from the palate, thereby reducing patient's postoperative discomfort and the risks associated with having a second surgical site.
13) Maharashtra (Mahārāṣṭra, Maha-rashtra):
Maharashtra is the Indian state where the study was conducted at a dental institution. Regional healthcare practices, patient demographics, and oral health awareness in Maharashtra can vary significantly, impacting the study's results and relevance of graft procedures among the local population's aesthetic expectations and treatment acceptance.
14) Observation:
Observation refers to systematically monitoring treatment outcomes and patient responses during the study. Clinical observations at baseline, 3 months, and 6 months post-surgery are vital to objectively evaluate the efficacy of treatments like ADMA and SCTG in achieving root coverage and improving periodontal health.
15) Measurement:
Measurement is crucial for quantifying clinical parameters like probing pocket depth and clinical attachment level. This study relied on precise measurements to evaluate the effectiveness of graft materials, thereby providing objective data necessary for drawing conclusions about the successful outcomes of gingival recession treatments.
16) Antibiotic (Antibacterial):
Antibiotics are prescribed post-surgery to prevent infection, a potential complication in periodontal procedures. In this study, the antibiotic regimen was an essential part of postoperative care to ensure optimal healing and to mitigate risks associated with bacterial contamination at the surgical site following graft placement.
17) Channel:
In the context of ADMA, 'channel' may refer to the preserved vascular channels in the graft that promote revascularization and integration into host tissue post-surgery. Understanding these channels is critical for evaluating how effectively the graft material can support healing and tissue regeneration.
18) Allergy:
Allergy refers to the body's hypersensitivity to substances, which could lead to adverse reactions in patients using graft materials. The study noted no postoperative complications related to allergies, indicating that the ADMA used was well-tolerated, reinforcing its safety as a grafting option in periodontal therapy.
19) Sharad (Śarad):
Sharad Pawar Dental College in Maharashtra is the institution where the study was conducted. The college's facilities, faculty, and patient demographic play an essential role in the study's execution and the credibility of its findings, impacting both research outcomes and educational contributions to dental practices.
20) Wardha:
Wardha is the city in Maharashtra where the research was carried out. Local healthcare dynamics, including patient accessibility and cultural attitudes toward dental aesthetics in Wardha, are relevant factors affecting study participant engagement and overall findings that may influence future periodontal treatments in similar settings.
21) Dish (Diś):
In the study context, a 'dish' may refer to the sterile container used to hydrate and prepare the ADMA graft prior to surgical implantation. Maintaining a sterile environment and proper hydration of graft materials is crucial for ensuring their effectiveness and biocompatibility in surgical procedures.
22) Life:
Life in this context relates to the longevity and health of grafted tissue over time. Studies of graft performance, such as ADMA, focus on the quality of life improvements for patients post-surgery, including aesthetic satisfaction and reduction in sensitivity, enhancing overall periodontal health outcomes.
23) Sign:
Sign refers to indicators of healing and recovery associated with the surgical techniques employed. In this study, the presence or absence of significant differences in clinical parameters before and after treatment serves as evidence for the effectiveness of ADMA compared to SCTG in root coverage outcomes.
24) Pain (Paiṇ):
Pain management is essential in postoperative care to ensure patient comfort and satisfaction. In this study, effective pain control strategies, including NSAIDs and antibiotics, were implemented post-surgery, which directly relate to patient recovery experiences and their overall perception of the treatment effectiveness.
25) Hand:
Hand instruments play a vital role in dental surgeries, allowing for precise manipulation of tissues and preparation of graft sites. The skillful use of hand instruments is essential for achieving favorable surgical outcomes, emphasizing the importance of technique in procedures evaluating different graft materials.
26) Gold (Golden):
Gold standard refers to an established benchmark of practice or treatment, in this case, SCTG for achieving root coverage. This study compares the newer ADMA to this gold standard, helping to ascertain if ADMA can offer similar efficacy, thereby influencing future treatment recommendations in the field.
Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Evaluation of acellular matrix vs. connective tissue for gum recessions.’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
Ethical committee, Probing pocket depth, Clinical attachment level, Gingival Recession, Clinical outcome, Periodontal therapy, Oral hygiene instruction, Clinical parameter, Initial therapy, Revascularization, Post operative complication, Systemic antibiotic.