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Journal of Stomatology Oral and Maxillofacial Surgery
Volume 119, n° 1
pages 25-32 (février 2018)
Doi : 10.1016/j.jormas.2017.09.005
Received : 7 January 2017 ;  accepted : 3 September 2017

Alternatives to connective tissue graft in the treatment of localized gingival recessions: A systematic review

K. Amine a, , Y. El Amrani b , S. Chemlali a , J. Kissa a
a Periodontics department, Casablanca dental school, Casablanca, Morocco 
b Casablanca dental school, Casablanca, Morocco 

Corresponding author. Rue Abou Al Alaa Zahar, BP 9157, 21100 Mers Sultan, Casablanca, Morocco.

The aim of this Systematic Review (SR) was to assess the clinical efficacy of alternatives procedures; Acellular Dermal Matrix (ADM), Xenogeneic Collagen Matrix (XCM), Enamel Matrix Derivative (EMD) and Platelet Rich Fibrin (PRF), compared to conventional procedures in the treatment of localized gingival recessions.

Material and methods

Electronic searches were performed to identify randomized clinical trials (RCTs) on treatment of single gingival recession with at least 6 months of follow-up. Applying guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses statement (PRISMA). The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool.


Eighteen randomized controlled trials (RCTs) with a total of 390 treated patients (606 recessions) were included. This systematic review showed that: Coronally Advanced Flap (CAF) in conjunction with ADM was significantly better than CAF alone, while the comparison between CAF+ADM and CTG was affected by large uncertainty. The CAF+EMD was significantly better than CAF alone, whereas the comparison between CAF+EMD and CTG was affected by large uncertainty. No significant difference was recorded when comparing CAF+XCM with CAF alone, and the comparison between CAF+XCM and CTG was affected by large uncertainty. The comparison between PRF and others technique was affected by large uncertainty.


ADM, XCM and EMD assisted to CAF might be considered alternatives of CTG in the treatment of Miller class I and II gingival recession.

The full text of this article is available in PDF format.

Keywords : Acellular dermis, Collagen, Dental enamel proteins, Platelet rich fibrin, Gingival recession, Randomized controlled trial

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