New attachment of surgically induced buccal gingival recessions using enamel matrix derivative. A histologic and histometric study in dogs

OBJECTIVES: The present study was designed to evaluate the healing process of gingival recession defects treated with enamel matrix derivative (EMD) and to compare it to that obtained with 24% ethylenediamine tetra acetic acid (EDTA) and the laterally repositioned flapsalone.MATERIALS and METHODS: Gingival recessions were surgically created on the buccal surfaces of maxillary canines and fourth premolars and mandibular firstmolarsofeightbeagledogs.Plaquewas allowed to accumulate for fiveweeks.Followingapreparationperiod,thedefectswererandomlyassignedtooneofthe three treatment groups (EMD, EDTA, and control groups). Four dogs each were sacrificedatthreeandsixmonthspost-treatment. Clinical parameters which included the gingival recession depth and width were measured, and the length of the total epithelium and connective tissue attachment were histometrically evaluated. RESULTS: All three treatments resulted in a statistically significantdecreaseofthegingivalrecessiondepthandwidthwhencomparedtothebaseline(P 0.05). Three and six months following surgery, EMD and EDTA groups demonstrated significantlyhigherpercentageof root coverage when compared to the control group. There was no statistically significantdifferenceinthepercentageofroot coverage between EMD and EDTA groups. Histologically, all three treatment groups demonstrated a new connective tissue attachment. Histometrically, EMD treated sites showed a statistically significantincreaseofnewconnectivetissueattachment when compared to the EDTA treated sites and controls at three and six months (P 0.05). The epithelium length was similar in the EMD and EDTA treated sites (P 0.05) and it was significantlyshorterintheEMDgroupwhencompared to the control group (P 0.05) at three and six months. There were no statistically significantdifferencesbetweenthe EDTA and control groups in the length of the epithelium and connective tissue attachment. CONCLUSION: EMD seemed to significantlyimprovetheclinicalandhistologicaloutcomesofgingivalrecessionstreatedbymeansofthelaterally repositioned flapsurgery.