A Comparative Study of Root Coverage using OrACELL™ Versus Subepithelial Connective Tissue Graft: A Randomized Controlled Trial

Gingival recession is defined as a mucogingival deformity that includes the apical displacement of the marginal soft tissues below the cemento-enamel junction, loss of attached gingiva, and exposure of root surfaces. The present study aims to compare root coverage outcomes between autogenous Connective Tissue Graft (CTG) and decellularized human dermis (OrACELL™) in areas of facial gingival recession.

Twenty-four non-smoking, healthy patients, with 2mm or greater facial gingival recession at a minimum of one site that is classified as Miller Class I, II, or III recession defects were included. Patients were randomly assigned to either control (CTG) or OrACELL™ (test) groups, which were treated with identical surgical techniques. All root coverage clinical parameters were evaluated at baseline, 3, and 6-months.

Eleven patients received CTG while 13 patients received OrACELL™; 23 of the 24 total patients had Miller Class III defects. Baseline mean Vertical Recession (VR) (CTG = 3.27±0.68 mm, OrACELL™ = 3.50±0.89 mm) and Clinical Attachment Level (CAL) (CTG = 4.86±0.74 mm, OrACELL™ = 4.73±0.90 mm) showed no significant difference between groups. At 6 months, mean VR (CTG = 0.59±0.70 mm, OrACELL™ = 1.19±1.07 mm) significantly decreased in both groups, whereas CAL (CTG = 1.90±1.00 mm, OrACELL™ = 2.42±1.17 mm) significantly increased in both groups. Differences between group means were not statistically significant.

VR and CAL improved significantly in both the CTG and OrACELL™ groups from baseline to 6 months post-operatively, with no significant differences between groups regarding VR or CAL over the course of the study. In Miller Class III recession defects, OrACELL™ provided a viable alternative to CTG with similar results.