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

Sean K. Vreeburg, Garth R. Griffiths, Jeffrey A. Rossmann*
Department of Periodontics,Texas A & M College of Dentistry, Dallas, TX 75246, USA

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© 2018 Vreeburg et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Periodontics, Texas A & M College of Dentistry, 3302 Gaston Avenue, Room 20.02, Dallas, TX 75246, USA, Tel: 214-828-8126, Fax: 214-874-4563, Email:



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.

Keywords: Gingival recession, Mucogingival deformities, Acellular dermal matrix, Decellularized human dermis, Connective tissue grafts, Subepithelial connective tissue grafts, Percent root coverage, Percent defect coverage.