A Modified Surgical Technique for Root Coverage With an Allograft: A 12-Month Randomized Clinical Trial

Background: The aim of this randomized controlled clinical study is to investigate whether a modified surgical technique could provide better results for root coverage and greater amounts of keratinized tissue (KT) with the acellular dermal matrix graft (ADMG). Methods: Fifteen bilateral Miller Class I or II gingival recessions (GRs) were selected. The recessions were treated and assigned randomly to the test group (TG), and the contralateral recessions were assigned to the control group (CG). The ADMG was used in both groups with differences in the graft positioning between them. The following clinical parameters were measured before the surgeries and after 12 months: 1) probing depth; 2) relative clinical attachment level; 3) GR; 4) thickness of KT (TKT); and 5) KT width. A new parameter, the GR area (GRA), was measured in standardized photographs using a special device and software. Results: There was no significant difference between groups in KT width and TKT parameters at the 12-month postoperative period. However, there was a significant difference between the gains in GR (Delta GR) and GRA (Delta GRA), favoring the TG after 12 months. The TG presented Delta GR = 3.04 +/- 0.29 mm and Delta GRA= 38,919 +/- 9,238 pixel square values (pix(2)), and the CG presented Delta GR= 2.61 +/- 0.41 mm and Delta GRA= 22,245 +/- 9,334 pix(2) (P < 0.05 and < 0.001, respectively). Conclusions: Both techniques were successful. The TG treatment was more effective in reducing GR and GRA. The flap and graft position may be of importance in root coverage procedures outcome.