Subpedicle connective tissue graft versus guided tissue regeneration with bioabsorbable membrane in the treatment of human gingival recession defects

THE PURPOSE OF THE PRESENT CLINICAL STUDY was to evaluate the effect of gui ded tissue regeneration (GTR) in comparison to subpedicle connective tissue graft (SCTG) in the treatment of gingival recession defects. A total of 12 patients, each contributing a pair of Miller's Class I or II buccal gingiv al recessions, was treated. According to a randomization list, one defect i n each patient received a polyglycolide/lactide bioabsorbable membrane, whi le the paired defect received a SCTG. Treatment effect was evaluated 6 mont hs postsurgery. Clinical recordings included full-mouth and defect-specific oral hygiene standards and gingival health, recession depth (RD), recessio n width (RW), probing depth(PD), clinical attachment level (CAL), and kerat inized tissue width (KT). Mean RD significantly decreased from 3.1 mm presu rgery to 1.5 mm at 6 months postsurgery for the GTR group (48% root coverag e), and from 3.0 mm to 0.5 mm for the SCTG group (81% root coverage). RD re duction and root coverage were significantly greater in SCTG group compared to GTR group. Mean CAL gain amounted to 1.7 mm for the GTR group, and 2.3 mm in the SCTG group. No significant differences in PD changes were observe d within and between groups. KT increased significantly from presurgery for both treatment groups, however gingival augmentation was significantly gre ater in the SCTG group compared to GTR group. Results indicate that: 1) tre atment of human gingival recession defects by means of both GTR and SCTG pr ocedures results in clinically and statistically significant improvement of the soft tissue conditions of the defect; and 2) treatment outcome was sig nificantly better following SCTG compared to GTR in terms of recession dept h reduction, root coverage, and keratinized tissue increase.