The use of amniotic membrane in dental root coverage surgery

Background and Objective: Gingival recession is defined as an apical displacement of soft tissues to the cementoenamel junction. There are Various treatment options for the management of gingival recessions include laterally positioned flap, guided tissue regeneration, free gingival autografts, coronally advanced flap (CAF) and autogenoussubepithelial connective tissue grafts. Among resorbable membranes, barrier membrane derived from placenta has been introduced for periodontal regeneration.The aim of the present study was to compare coronally advanced flap (CAF) plus amniotic membrane (AM) to CAF with connective tissue graft (CTG) in the treatment of Miller’s class I and II gingival recessions.Materials and Methods: This review has been done by searching in electronic data bases including pubmed and scopus with these key words amniotic membrane , CAF , root coverage .Finding: For all patients, plaque index, gingival index, bleeding on probing, clinical attachment level, depth of recession, width of recession, width of attached gingiva, and gingival thickness were evaluated at 6 months and 18 months postoperatively. The results of the study revealed statistically no significant difference in dental PI improved, GI and probing pocket depth in both groups. Significant reduction in gingival recession defects and gain in clinical attachment level was observed in both the groups. The present results suggest that the combined approachof CAF and amniotic membrane can be considered as a treatment option for multiple adjacentgingival recessions.Gingival recession is defined as an apical displacement of soft tissues tothe cementoenamel junction. Various treatment options for the management of gingivalrecessions include laterally positioned flap, double papillae flap, coronally advanced flap(CAF) with or without guided tissue regeneration, free gingival autografts, and autogenoussubepithelial connective tissue grafts. Three patients with multiple adjacent gingival recessionsin the upper jaw were treated utilizing amniotic membrane (Tata memorial) with CAF. Theresults of this procedure show that amniotic membrane can be used in the treatment of gingivalrecession defects with significant root coverage and to increase the thickness of keratinizedgingiva. There was an increase in height and thickness of keratinized gingiva from 3 to 3.5 mmand 1.5 to 2 mm, respectively. The present results suggest that the combined approach of CAFand amniotic membrane can be considered as a treatment option for multiple adjacent gingivalrecessions.Conclusion: The results of this research showed that application of AM instead of connective tissue decreased surgical operation time and patient discomfort but the amount of root coverage was not significantly different between the two methods

Keywords:

guided tissue regeneration , gingival recession , coronally advanced flap