Coverage of Gingival Recession Using GTR With and Without EMD

Objectives: The goal of periodontal therapy is to restore supportive tissues destroyed by periodontal disease. Esthetics are also another important matter that must be considered. When GTR is applied to wide or deep periodontal defects resulting from gingival recession, root coverage ranges from 64% ~ 95.2%, which is problematically low, clinically. The objective of this study was to clarify the effect of the adjunctive use of EMD on ePTFE membrane GTR-based root coverage.

Methods: The Beagle dogs were used. Gingival recession defects (6 × 5 mm: vertical × horizontal ) were surgically created in the maxillary of canines. Full thickness flaps were raised and root surfaces were scaled and planed. The apical notch was placed at the obtained defect ( bone level ) and the coronal notch was placed at the cemento-enamel junction. These areas were treated with either GTR plus EMD, with GTR alone, or with neither GTR nor EMD as a control. The animals were euthanasiaed with an intravenous overdose of sodium pentobarbital at 2, 4 and 8 weeks.

Result: During the healing period, the gingiva adjacent to all the teeth treated exhibited only minute clinical signs of inflammation. No exposure of membrane was seen in the membrane-treated teeth. The control group was characterized by long junctional epithelium and little bone formation. The GTR-plus-EMD group showed a statistically significant increase (p<0.01) in new bone and cementum formation compared with the GTR-alone group.

Conclusion: The results of the present investigation suggest that adjunctive use of EMD with GTR promote formation of new bone and cementum without root resorption in recession- type defects in canine.