Comparison of 2 clinical techniques for treatment of gingival recession

Background: In early case studies, use of a Collagen barrier as a guided ti ssue regeneration (GTR) material has shown particular promise in procedures aimed at root coverage. The similarities between Collagen membrane and sub epithelial connective tissue graft (SCTG) have made Collagen membrane an at tractive and a possible alternative material for root coverage. The purpose of this randomized clinical trial was to compare these 2 techniques, SCTG versus a GTR-based procedure (GTRC), for root coverage/recession treatment. Methods: Sixteen patients with bilateral Miller's Class I or II (gingival r ecession greater than or equal to3.0 mm) recession defects were treated eit her with SCTG or GTRC using a newly designed Collagen membrane. Clinical pa rameters monitored included recession depth (RD), clinical attachment level (CAL), probing depth (PD), width of keratinized gingiva (KG), attached gin giva (AG), and recession width (RW), each measured at the mid-buccal area t o the nearest 0.5 mm. Measurements were taken at baseline and 6 months. A s tandard mucogingival surgical procedure was performed. Data were reported a s means +/- SD and were analyzed using the paired t test for univariate ana lysis and restricted/residual maximal likelihood (REML)-based mixed effect model for multivariate analysis. Results: No statistically significant differences were observed in RD, CAL, KG, and AG between test and control groups at either time period. However, SCTG showed significantly more residual PD and more RW gain when compared to GTRC at 6 months. Both treatments resulted in a statistically significan t (P <0.05) reduction of recession defects (2.5 mm and 2.8 mm), gain of CAL (2.8 mm and 2.3 mm), reduction of RW (1.9 mm and 2.7 mm), and increase of KG (0.7 mm and 1.1 mm) and AG (0.7 mm and 0.5 mm) for GTRC and SCTG, respec tively, when comparing 6-month data to baseline. Mean root coverage of 73% (Collagen membrane) and 84% (subepithelial connective tissue graft) was ach ieved. Conclusions: The 2 techniques are clinically comparable. Use of a modified Collagen membrane to attain root coverage may alleviate the need for donor site procurement of connective tissue.