Treatment of human mucogingival defects utilizing a bioabsorbable membranewith and without a demineralized freeze-dried bone allograft

Background: The use of guided tissue regeneration (GTR) has become an effec tive procedure for the treatment of gingival recession. No reports exist on the use of a bioabsorbable membrane in combination with a demineralized fr eeze-dried bone allograft (DFDBA) for the treatment of these defects. Methods: Fourteen (14) patients with 17 recession defects were included in this clinical study. Each patient had at least 1 tooth with 3 mm or greater marginal tissue recession on the facial surface as measured from the cemen to-enamel junction (CEJ). Each patient was treated by GTR using a bioabsorb able membrane. When the first patient presented for inclusion in the study, a coin was flipped to determine if the tooth being treated would be a test tooth (DFDBA) or a control tooth (no DFDBA). Each subsequent patient was a lternated between test and control. Immediately prior to the surgical proce dure, measurements were made which included recession depth, recession widt h at the widest point, probing depth, amount of keratinized tissue, and mar ginal tissue thickness. Local anesthesia was administered, and a measuremen t from the CEJ to the bone crest was made by sounding through the attachmen t. Results: The mean initial recession for all defects was 3.35 mm (SD +/- 0.4 9) and at 6 months postsurgery, mean recession was 0.47 mm (SD +/- 0.62). T his correlated to 86% root coverage for both treatments. For all defects tr eated, there was a statistically significant increase in keratinized tissue (mean 0.88 mm) and tissue thickness (mean 0.47 mm) and a significant decre ase in probing bone level (mean 0.76 mm). No statistically significant diff erences were observed between groups for any parameter. Conclusions: Although only 14 subjects with 17 defects were included in thi s study, the results suggest that the treatment of human gingival recession with a bioabsorbable membrane with or without the use of DFDBA results in significant root coverage, and slight, but significant improvements in kera tinized tissue, tissue thickness, and bone level. The greatest limitation o f the study was its lack of statistical power. Twenty-two (22) subjects wou ld have been required for the results of the study to show equivalence betw een groups.