Case 1: Before
Case 2: Before
Root Coverage using Acellular Dermal Matrix
Gingival recession compromises esthetics, comfort (via hypersensitivity) and, in cases of severe attachment loss, possibly tooth longevity. Numerous etiologies explain the presence of recession: periodontal diseases, thin gingiva and bone, orthodontic movement, subgingival restorations, abrasion, erosion, periodontal therapy, snuff use, foreign body impaction, periand intraoral piercings, high frenum, or muscle attachment. There appear to be as many ways to resolve it.1Indeed, the majority of research in periodontal plastic surgery concerns root coverage, especially as society increasingly focuses on appearance enhancement.
Acellular dermal matrix (ADM) allografts have been in use in medicine for skin replacement, lip augmentation, and other reconstructive surgery. Their fabrication entails processing of human dermis to remove cells and render HIV and hepatitis C levels nondetectable. No reported cases of disease transmission exist. An ADM contains no immunogenic cellular components but retains intact, nonimmunogenic vasculature, collagen, ground substance, and elastic fibers, which promote host-cell establishment.11,12 Like dermis, the material has two sides: the basement membrane side, which is smooth and not blood absorbent; and the connective tissue side, which is rough and blood absorbent.11,12 With such properties, an ADM may serve as a membrane for guided tissue regeneration.
One-time-only treatment appointments save time, boost productivity, and minimize discomfort. Often performed under conscious sedation, this approach to therapy avoids multiple surgeries and recovery periods and reduces time away from work, thus expediting treatment completion.