Root coverage of gingival recessions using acellular dermal matrix: a case report
Keywords:
Gingival recession, acellular dermal matrix, coronally advanced flap, root coverage, mucogingival surgery.Abstract
Introduction: Gingival recessions are characterized by the apical migration of the gingival margin, leading to root exposure, dentin hypersensitivity, and aesthetic concerns. Although the subepithelial connective tissue graft remains the gold standard for root coverage, acellular dermal matrix (ADM) has emerged as an alternative due to its ability to reduce donor-site morbidity and provide an unlimited supply of graft material. Objective: To present a clinical case of root coverage in gingival recessions using ADM, highlighting its clinical and aesthetic outcomes. Case Presentation: A 43-year-old female patient with no relevant medical history sought treatment due to aesthetic concerns and dentin hypersensitivity in the maxillary premolar region. Clinical examination revealed RT1 gingival recessions affecting teeth 24 and 25, according to the Cairo classification. Initial periodontal therapy was performed, including oral hygiene instruction and plaque control. Subsequently, a coronally advanced flap procedure was carried out with placement of a previously hydrated ADM over the conditioned root surfaces. Eighteen-month follow-up demonstrated satisfactory root coverage, improvement of hypersensitivity, and high aesthetic satisfaction reported by the patient. Discussion: ADM represents a predictable alternative to connective tissue grafts, avoiding donor-site morbidity and reducing surgical time. Several studies have reported comparable root coverage rates, particularly in RT1 and RT2 recessions according to the Cairo classification. In the present case, favorable clinical outcomes were achieved, supporting the usefulness of this biomaterial in periodontal practice. Conclusions: ADM is an effective and safe option for root coverage in gingival recessions, offering functional and aesthetic benefits. Its use may be considered a valid alternative to autologous connective tissue grafts.
Downloads
References
The American Academy of Periodontology. Glossary of periodontal terms. 4th ed. Chicago: The American Academy of Periodontology; 2001. p. 44.
Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Periodontol [Internet]. 2018;89 Suppl 1(S1):S204-13. Disponible en: http://dx.doi.org/10.1002/JPER.16-0671
Montero E, Caffesse R, Zabalegui I, Santacruz MG, Alonso MS. Recubrimiento radicular en el quinto sextante. Gaceta dental: Industria y profesiones [Internet]. 2017 [citado 26 de enero de 2026];(291):124-35. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=5979178
Dominiak M, Gedrange T. New perspectives in the diagnostic of gingival recession. Adv Clin Exp Med [Internet]. 2014; 23 (6): 857 863. Disponible en: http://dx.doi.org/10.17219/acem/27907
Wennstrom JL, Zucchelli G. Tratamiento mucogingival: cirugía plástica periodontal. En: Lang N, Lindhe J, Berglundh T, Giannobile WV, Sanz M. Periodontología clínica e implantología odontológica. Tomo 2. 6a ed. Buenos Aires: Médica Panamericana; 2017. pp. 969-1042.
Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study: Interproximal CAL for gingival recessions. J Clin Periodontol [Internet]. 2011;38(7):661-6. Disponible en: http://dx.doi.org/10.1111/j.1600-051X.2011.01732.x
Newman MG, Takei H, Klokkevold PR, Carranza FA. Newman and Carranza’s clinical periodontology. 13.a ed. Filadelfia, PA, Estados Unidos de América: Saunders; 2021.
Woofter C. The prevalence and etiology of gingival recession. Periodontal Abstr. 1969;17(2):45-50.
Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol [Internet]. 2018; 45 Suppl 20: S1-S8. Disponible en: http://dx.doi.org/10.1111/jcpe.12935
Chambrone L, Salinas Ortega MA, Sukekava F, Rotundo R, Kalemaj Z, Buti J et al. Root coverage procedures for treating localised and multiple recession-type defects. Cochrane Database Syst Rev [Internet]. 2018; 10: CD007161. Disponible en: http://dx.doi. org/10.1002/14651858.CD007161.pub3
Harris RJ. Clinical evaluation of 3 techniques to augment keratinized tissue without root coverage. J Periodontol [Internet]. 2001;72(7):932-8. Disponible en: http://dx.doi.org/10.1902/jop.2001.72.7.932
Tal H, Moses O, Zohar R, Meir H, Nemcovsky C. Root coverage of advanced gingival recession: a comparative study between acellular dermal matrix allograft and subepithelial connective tissue grafts. J Periodontol [Internet]. 2002;73(12):1405-11. Disponible en: http://dx.doi.org/10.1902/jop.2002.73.12.1405
Graziani F, Gennai S, Roldán S, Discepoli N, Buti J, Madianos P et al. Efficacy of periodontal plastic procedures in the treatment of multiple gingival recessions. J Clin Periodontol [Internet]. 2014; 41 Suppl 15: S63-S76. Disponible en: http://dx.doi.org/10.1111/jcpe.12172
Wei PC, Laurell L, Geivelis M, Lingen MW, Maddalozzo D. Acellular dermal matrix allografts to achieve increased attached gingiva. Part 1. A clinical study. J Periodontol [Internet]. 2000; 71 (8): 1297-1305. Disponible en: http://dx.doi.org/10.1902/jop.2000.71.8.1297
Zucchelli G, Amore C, Sforza NM, Montebugnoli L, De Sanctis M. Bilaminar techniques for the treatment of recession-type defects. A comparative clinical study: Bilaminar techniques for the treatment of recession-type defects. J Clin Periodontol [Internet]. 2003; 30 (10): 862-870. Disponible en: http://dx.doi.org/10.1034/j.1600-051x.2003.00397.x
