Tissue-engineered approach using autologous fibroblast-seeded volume-stable collagen matrix for managing gingival recession- A randomized controlled clinical trial

Background Gingival recession is a common deformity, and tissue engineering, using active regeneration, is emerging as a modern approach for management. This study aimed to evaluate the efficacy of autologous gingival fibroblasts seeded onto a volume-stable collagen matrix (VSCM) in treating gingival recession. Materials and methods A split-mouth randomized controlled clinical trial was conducted on 20 sites in 10 patients presenting with Miller Class I and II gingival recession. Sites were allocated to receive either coronally advanced flap (CAF) with volume-stable collagen matrix (VSCM) (control) or CAF with fibroblast-seeded volume-stable collagen matrix (FVSCM) (test). Autologous gingival fibroblasts were cultured and seeded onto VSCM before transplantation. Plaque index (PI), probing depth (PD), clinical attachment level (CAL), recession depth (RD), recession width (RW), and keratinized tissue width (KTW) were recorded at baseline, 1, 3, and 6 months. Secondary outcomes included Early Healing Score (EHS), Root Coverage Esthetic Score (RCES), and Visual Analog Scale (VAS). Statistical analysis was performed using SPSS (V23) and p < 0.05 was considered significant. Results Both groups demonstrated significant improvements in clinical parameters over time. The test group showed significantly greater CAL gain and reduction in RD and RW at all follow-up intervals, with sustained outcomes at 6 months. PI and PD remained comparable between groups. Although EHS, RCES, and KTW showed favourable trends in the test group, differences were not statistically significant. Conclusion Autologous fibroblast-seeded collagen membranes show promise as a biologically driven alternative for managing gingival recession. Further multicentric trials are warranted for long-term validation.