Split-mouth evaluation of connective tissue graft with or without enamel matrix derivative for the treatment of isolated gingival recession defects in dogs.

Shirakata, Yoshinori; Nakamura, T; Shinohara, Y; Nakamura-Hasegawa, K; Hashiguchi, C; Takeuchi, N; Imafuji, T; Sculean, Anton; Noguchi, K (2019). Split-mouth evaluation of connective tissue graft with or without enamel matrix derivative for the treatment of isolated gingival recession defects in dogs. Clinical oral investigations, 23(8), pp. 3339-3349. Springer-Verlag 10.1007/s00784-018-2750-1

[img] Text
Shirakata2018_Article_Split-mouthEvaluationOfConnect.pdf - Published Version
Restricted to registered users only until 2 December 2022.
Available under License Publisher holds Copyright.

Download (3MB) | Request a copy

OBJECTIVES The potential additive effect of an enamel matrix derivative (EMD) to a subepithelial connective tissue graft (CTG) for recession coverage is still controversially discussed. Therefore, the aim of this study was to histologically evaluate the healing of gingival recessions treated with coronally advanced flap (CAF) and CTG with or without EMD in dogs. MATERIALS AND METHODS Gingival recession defects (5 mm wide and 7 mm deep) were surgically created on the labial side of bilateral maxillary canines in 7 dogs. After 8 weeks of plaque accumulation and subsequent 2 weeks of chemical plaque control, the 14 chronic defects were randomized to receive either CAF with CTG (CAF/CTG) or CAF with CTG and EMD (CAF/CTG/EMD). The animals were sacrificed 10 weeks after reconstructive surgery for histologic evaluation. RESULTS Treatment with CAF/CTG/EMD demonstrated statistically significantly better results in terms of probing pocket depth reduction (P < 0.05) and clinical attachment level gain (P < 0.001). The length of the epithelium was statistically significantly shorter in the CAF/CTG/EMD group than in the CAF/CTG group (1.00 ± 0.75 mm vs. 2.38 ± 1.48 mm, respectively, P < 0.01). Cementum formation was statistically significantly greater in the CAF/CTG/EMD group than following treatment with the CAF/CTG group (3.20 ± 0.89 mm vs. 1.88 ± 1.58 mm, respectively, P < 0.01). The CAF/CTG/EMD group showed statistically significantly greater complete periodontal regeneration (i.e., new cementum, new periodontal ligament, and new bone) than treatment with CAF/CTG (0.54 ± 0.73 mm vs. 0.07 ± 0.27 mm, respectively, P < 0.05). CONCLUSION Within their limits, the present findings indicate that the additional use of EMD in conjunction with CAF + CTG favors periodontal regeneration in gingival recession defects. CLINICAL RELEVANCE The present findings support the use of EMD combined with CTG and CAF for promoting periodontal regeneration in isolated gingival recession defects.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Periodontology
04 Faculty of Medicine > School of Dental Medicine > School of Dental Medicine, Periodontics Research

UniBE Contributor:

Shirakata, Yoshinori and Sculean, Anton


600 Technology > 610 Medicine & health








Doris Burri

Date Deposited:

26 Jun 2019 10:40

Last Modified:

23 Oct 2019 20:07

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Animal study Coronally advanced flap Enamel matrix derivative Gingival recession Histological investigation Subepithelial connective tissue graft





Actions (login required)

Edit item Edit item
Provide Feedback