Collagen matrix used with a coronally advanced flap was compared to a connective tissue graft used with a coronally advanced flap at 6 months and 5 years for root coverage achieved.
Seventeen patients were available for the 5-year recall. Mean root coverage between 6 months and 5 years changed from 89.5% to 77.6% for collagen matrix and 97.5% to 95.5% for connective tissue. There was no significant difference between the therapies for changes in root coverage, keratinized tissue width, and probing depth. Patient satisfaction was similar for both therapies.
Collagen matrix is a viable long term alternative to traditional autogenous connective tissue when used in conjunction with a coronally advanced flap for root coverage procedures.
Dr. G’s comments:
There is a trend for slightly better root coverage with autogenous tissue, but patients seem to prefer the lower morbidity of an allograft.
For more information please refer to:
J Periodontol. 2016 Mar;87(3):221-7
Long-Term Results Comparing Xenogeneic Collagen Matrix and Autogenous Connective Tissue Grafts With Coronally Advanced Flaps for Treatment of Dehiscence-Type Recession Defects.
McGuire MK, Scheyer ET
A meta-analysis of randomized clinical trials that assessed single tooth class I or II recession defects treated surgically with a coronally advanced flap. Early (less than 10 days post-op) and late (more than 10 days post-op) suture removal were compared in terms of differences in complete root coverage outcome.
Data from seventeen studies comprising of 325 single recession defects revealed a superior proportion of sites exhibiting complete root coverage when sutures where removed more than 10 days post-operatively. No significant difference in outcomes between absorbable and non-absorbable sutures when they were removed more than 10 days after surgery.
Early suture removal (less than 10 days post-op) can hinder complete root coverage outcomes in singe tooth recession defects treated with a coronally advanced flap.
Dr. Gebrael’s comments:
Modern 5-0 polypropylene sutures have excellent tensile characteristics and are comfortable enough for us to delay suture removal until at least one month post-op. This allows a mature attachment to form and increases the odds for complete root coverage.
For more information please refer to: J Periodontol. 2016 Feb;87(2):148-55
The Effect of Suturing Protocols on Coronally Advanced Flap Root-Coverage Outcomes: A Meta-Analysis
Tatakis DN, Chambrone L