Root coverage in Miller's Class I and II gingival recession using acellular dermal matrix and subepithelial connective tissue graft: A systematic review.

Background: Subepithelial connective tissue graft (SCTG) is considered the gold standard in the treatment of gingival recession. Donor site morbidity has led to the introduction of non-autogenous grafts such as acellular dermal matrix (ADM). This systematic review compared SCTG with ADM to treat root coverage in Miller's Class I and Class II gingival recession. Methods: Articles in PubMed (11), Scopus (1), EBSCO (2), and Google Scholar (1) were incorporated in this study. The studies included randomized controlled trials from 1st January 2011 to 31st December 2022. Studies that compared root coverage and reduction in recession depth using SCTG and ADM grafts were included in the review. Fourteen randomized control trials (RCTs) were included in this systematic review following the PRISMA guidelines. The risk bias assessment was assessed using the ROBINS-2 tool. Results: Of the 14 included studies, 11 articles concluded that ADM is as effective as SCTG for treating root coverage in Class I and Class II gingival recession. However, 3 studies showed a statistically significant difference between SCTG and ADM results, indicating better root coverage achieved with SCTG than with ADM. Conclusion: ADMs may be an alternative treatment in cases where multiple areas of recession where SCTGs harvested from the palate area would be insufficient.