Efficacy of Acellular Dermal Matrix Versus Connective Tissue Graft for Root Coverage in Patients with Gingival Recession: A Meta-Analysis.

Abstract

This study aimed to compare the efficacy of acellular dermal matrix (ADM) versus connective tissue graft (CTG) for root coverage in patients with gingival recession. Randomized controlled trials (RCTs) on the comparison of ADM with CTG in adult patients with gingival recession were searched in multiple databases updated on 15th May 2020. The quality of studies was evaluated using the upgraded Jadad scale. Included studies were assessed for percent root coverage (PRC), clinical attachment level (CAL), keratinized tissue (KT), probing depth (PD), recession width (RW) and recession depth (RD). Weighted mean difference (WMD) was used as the statistics for measurement data and the effect sizes were expressed as 95% confidence intervals (CI). Totally 24 RCTs were eligible for the final analysis. The patients accepting ADM had a higher gain in CAL (WMD: 0.250, 95%CI: 0.030-0.470, P=0.026) but a smaller gain in KT width (WMD: -0.440, 95%CI: -0.629--0.252, P<0.001) than those receiving CTG. No significant differences were found between the patients accepting ADM and those undergoing CTG in PRC (WMD: -1.608, 95%CI: -3.491-0.275, P=0.094), PD (WMD: 0.066, 95%CI: -0.005-0.137, P=0.067), RW (WMD: 0.065, 95%CI: -0.098-0.228, P=0.437) and RD (WMD: 0.109, 95%CI: -0.095-0.314, P=0.294). Overall, the ADM treatment for patients with gingival recession may be superior to CTG in gaining CAL, but CTG has a significant advantage over ADM in gaining KT width.