Allogeneic acellular dermal matrix versus connective tissue graft for multiple RT2 gingival recessions: a randomized controlled trial

Acellular dermal matrix (ADM) is an alternative to autologous tissue grafts that are commonly utilized in soft tissue augmentation procedures. This randomized clinical trial evaluated the clinical effectiveness of allogeneic ADM versus connective tissue graft (CTG) in treating multiple recession type (RT) 2 gingival recessions using a modified tunnel technique. A total of 40 patients were randomly assigned to either the CTG group (n=20) or the ADM group (n=20). Clinical parameters, including the plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), recession depth (RD), and gingival thickness (GT), were assessed at baseline and 12 months. Both groups showed significant improvements in CAL, KTW, RD, and GT at 12 months compared to baseline. No significant differences in PI, GI, PD, mean root coverage (MRC), complete root coverage (CRC) or the Root Coverage Esthetic Score (RES) were observed between the CTG and ADM groups. The CTG group demonstrated greater gains in GT and KTW (p<0.05), whereas the ADM group reported significantly lower postoperative pain (p<0.05). ADM and CTG yielded comparable root coverage and aesthetics. CTG provided superior tissue augmentation, whereas ADM offered better patient comfort. In conclusion, allogeneic ADM is a promising alternative for the treatment of RT2 gingival recessions.