Porcine Collagen Matrix With and Without Enamel Matrix Derivative for the Treatment of Gingival Recession Defects
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Gingival Recession
- Sponsor
- Walter Reed National Military Medical Center
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Change in Clinical Attachment Levels
- Last Updated
- 6 years ago
Overview
Brief Summary
The purpose of this prospective, double-blinded, randomized, split-mouth study is to compare the effectiveness of a porcine collagen matrix (CM) and coronally advanced flap (CAF) with or without the addition of enamel matrix derivative (EMD) in the treatment of Miller Class I, II, or predictable class III recession defects. One defect will receive CM + CAF + EMD (Experimental), while the other will receive CM + CAF (Control) alone. The treatment of 60 similarly sized Miller class I, II, or predictable class III recession defects on single-rooted teeth in 30 subjects using CM + CAF + EMD or CM + CAF alone will be evaluated. The subjects will be in good health, non-smokers, periodontally healthy with good oral hygiene and have no contraindications to periodontal surgery. Paired, similar sized defects on single-rooted teeth will be in the same subject and measure within 2mm of each other. One defect will be randomly assigned as the test group using CM + CAF + EMD, and the other as the control group using only CM + CAF. Clinical measurements will be made using a UNC-15 periodontal probe by calibrated, board certified periodontists and will include: probing depth (PD), clinical attachment level (CAL), vertical recession (RD), and width of keratinized tissue (KT). Percent root coverage (%RC) will be calculated. The measurements will be used to evaluate surgical outcome. Surgical outcome will also be assessed using stone models. All measurements will be taken at baseline (on the day of the surgery) and 3 and 6 months post-surgery for comparison.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age 18 years or over
- •Patient will remain in the Capital region for at least 6 months following the surgical procedure for follow up appointments
- •Patient must be otherwise periodontally healthy
- •Patient must be systemically healthy (ASA class I or II)
- •Patient must have no contraindications to periodontal surgery
- •Patient must have demonstrated good oral hygiene (plaque index \<1 according to Silness and Löe)
- •Paired Miller Class I, II or predictable III recession defects
- •Bilateral, facial defects on single-rooted teeth
Exclusion Criteria
- •Self-reported history of smoking within previous 6 months
- •Does not meet any of the preceding criteria
- •Female patients who are pregnant or nursing
- •Antibiotic medications taken within the last 6 months
- •History of mucogingival surgery at the sites of interest
- •Poor plaque control (\>25% of sites)
- •Those with clinically significant systemic disease, which may affect healing (i.e. uncontrolled diabetes or bone metabolic disease)
- •Allergy to chlorhexidine gluconate (Peridex)
- •Does not sign study consent or HIPAA forms
- •Bleeding complications (e.g. hemophilia)
Outcomes
Primary Outcomes
Change in Clinical Attachment Levels
Time Frame: Baseline to 6 months
Change in Clinical Attachment Levels measurements from baseline to 6 months
Change in gingival recession using conventional measurements
Time Frame: Baseline to 6 months
Change in gingival recession measurements from baseline to 6 months
Change in root coverage using digital analysis
Time Frame: Baseline to 6 months
Assessment of surgical outcome by optically scanning stone models captured at baseline to 6 months post-surgery. The digital files will be aligned using global registration and GR recorded by measuring the distance from cemento-enamel junction to the height of the marginal gingiva using computer software. % RC will be calculated by comparing GR at the various times.
Change in Keratinized Tissue
Time Frame: Baseline to 6 months
Change in Keratinized Tissue measurements from baseline to 6 months
Change in Probing Depths
Time Frame: Baseline to 6 months
Change in Probing Depthmeasurements from baseline to 6 months
Secondary Outcomes
- Comparison of digital vs. conventional measurement(Baseline to 6 months)