LAUSR

BACKGROUND This study compared clinical and patient-centered outcomes of sub-epithelial connective tissue graft (CTG) with and without enamel matrix derivative (EMD) in the treatment of Multiple Class III-IV Miller periodontal recession defects on lower anterior teeth. METHODS This randomized clinical study evaluated 41 patients over 3 years follow up. 156 teeth were divided into two groups: Test (CTG-EMD- 79 teeth) and Control (CTG only- 77 teeth). Clinical Recession (REC), Keratinized Tissue (KT) width, % root coverage, patient centered outcomes were compared between the two groups. RESULTS At 36 months follow up, patient level analysis showed that REC in the test group reduced significantly (5.71±0.58 mm to 1.57±0.85 mm) compared to the control group (5.94±0.46 mm to 2.51±0.62 mm) (p<0.001), while KT width increase in the test group (1.51±0.26 mm to 4.18±0.34 mm) was significantly greater than the control group (1.65± 0.21 mm to 2.90±0.20 mm) (p<0.001). At 36 months, tooth level analysis (Class III and Class IV groups) found less residual REC and increased KT in the test group compared to the control group (p<.01). Significantly less pain was reported at 2nd , 7th and 14 days follow-up post-surgery in the test group (p<0.001). CONCLUSIONS The addition of EMD to CTG results in improved root coverage outcomes and higher amounts of keratinized tissue width 36 months after treatment of Class III-IV recession on mandibular anterior teeth. The adjunctive use of EMD also resulted in significantly reduced pain 14 days after the surgery. This article is protected by copyright. All rights reserved.