The Comparison of subepithelial connective tissue graft and resorbable membranes in the treatment of dehissens type defects

Lokalized gingival recessions present an important clinical problem both for the clinicans and patients. Several surgical procedures have been proposed to achieve predictable root coverage. Use of free connective tissue autografts as a support to coronally repositioned flaps have been demonstrated to be a predictable technique with high success rate. Recently Guided Tissue Regeneration (GTR) technique have also been shown to produce predictable and favorable results. In the present study, 30 bilateral matched pairs of lokalized buccal recessions (Class I and II ) on single rooted teeth were treated. The treatment alternatives were: Use of free Connective Tissue Autografts (CTG) and GTR procedure. For GTR procedure two types of resorbable barriers were used, namely Resolut® and Tutoplast Dura®. The selected pairs of teeth randomly assigned to consist three groups. In the first group CTG and Resolut® were compared, in the second group CTG and Tutoplast Dura® were compared and finally in the third group Resolut® and Tutoplast Dura® were compared. In all groups a trapezoidal flap with large base was raised beyond the mucogingival junction. The exposed root surface was scaled to produce a flat or concave shape. Following placement of a free connective tissue autograft or a GTR barrier, the flap was mobilized coronally to cover the material completely and then sutured. The height of gingival recession, width of keratinized tissue, clinical attachment level and probing depth measurements were assessed at baseline, 10 weeks, 3, 6, 9 and 12 months after surgery. The amount of root coverage 74.28 % for Resolut®, 69.62 % for Tutoplast Dura® and 86.31 % for CTG. The average attachment gain was 48.79 % (2.83 mm) for Resolut®, 45.31 % (2.90 mm) for Tutoplast Dura® and 57.41% (3.37 mm) for CTG. The gain in the height of keratinized gingiva was 0.53 mm for Resolut®, 0.50 mm for Tutoplast Dura® and 2.05 mm for CTG. The reduction in probing depth was 0.23 mm for Resolut®, 0.15 mm for Tutoplast Dura® and -0.10 mm for CTG. The resuls demonstrated that the use of resorbable barriers via GTR technique produced a predictable outcome for the teratment of localized recessions.