Subgingival acellular dermal matrix allograft for the treatment of gingival recession: A case report

Root coverage procedures using subgingival soft tissue grafts-or guided tis sue regeneration have attracted much interest within the past 2 decades. Re cently, acellular dermal matrix allograft (ADMA) has been introduced as a s ubstitute for palatal donor tissue-in gingival augmentation procedures. Thi s study was undertaken to examine the potential of ADMA to be used as a sub stitute for autogenous connective tissue graft material in a root coverage procedure in a case with moderate gingival recession combined with reduced keratinized attached gingiva. After thorough roof planing and conditioning of the root surface with a saturated solution of tetracycline-HCl, a trapez oidal mucoperiosteal flap was raised and the papillae were de-epithelialize d. The exposed bone surrounding the exposed root surface was perforated wit h a No. 2 round drill, and the exposed root and surrounding bone were cover ed by ADMA. The allograft was stabilized by 5-0 vicryl sutures. The flap wa s coronally positioned to completely cover the ADMA. Healing was uneventful . Eight-month observations and measurements showed root coverage of more th an 3.5 mm (>80%), a gingival margin that was harmonious with the neighborin g teeth, and an increase of the zone of keratinized attached gingiva, from I to 3 mm. Within the limitations of these clinical observations, it is sug gested that ADMA may be a possible substitute to free autogenous connective tissue grafts and/or bioabsorbable barrier membranes. Further clinical and histological studies are necessary to understand the healing process of th is surgical wound.