The Effect of Enamel Matrix Derivatives on Root Coverage: a 12-Month Follow-Up of a Randomized Clinical Trial

Abstract

Subepithelial connective tissue grafts (SCTGs) with a coronally advanced flap (CAF) are accepted as the gold standard for covering denuded root surfaces. In recent years, enamel matrix derivatives (EMDs) have been used for their regenerative potential in periodontics. The aim of this split-mouth and randomized controlled study was to assess the clinical and aesthetical impacts of EMD application in combination with SCTG+CAF in patients with Miller's Class I and II gingival recessions in contralateral canines of the maxilla. Participants who underwent SCTG+CAF+EMD application were identified as the test group (n = 19) and those who underwent SCTG+CAF as control group (n = 19). The outcome parameters were recession depth/width, root coverage percentage, and root coverage aesthetic score (RES). RES was evaluated by two calibrated blind periodontists one year after the treatment. Statistically significant root coverage percentage was observed at one year post-treatment for both groups (p < 0.05). However, significant differences between the groups were not observed in terms of total RES and complete root coverage rate (p > 0.05). The test group had significantly better results than the control according to the soft tissue texture and mucogingival junction alignment results (p < 0.05). These results indicate that EMDs contribute to the healing of soft tissue without scarring. As a result of better wound healing, the EMD-added group exhibited better results in terms of the harmony of the mucogingival junction between adjacent teeth. This paper is the first split-mouth study in which SCTG+CAF and SCTG+CAF+EMD were compared using RES in bilateral canines.