Background: The aim of this study was to compare root coverage using acellular dermal matrix (ADM) with and without enamel matrix derivative (EMD) on the percentage of root coverage, probing attachment level, and the amount of keratinized tissue in the treatment of localized recession. Methods: Eighty-two contralateral sites in 14 patients with ≥2 mm of Miller Class I or III buccal tissue recession were treated. Forty-one test sites were treated with coronally advanced flap (CAF) using ADM in conjunction with EMD, whereas 41 control sites were treated with CAF using ADM alone. A split-mouth design was used for this study with 82 sites. Patients were followed for 3 and 6 months. A paired t test was conducted with the subject as the unit of analysis. Results: Based on paired t tests, both groups had significant improvement in the percentage of root coverage, probing attachment levels, and increased keratinized tissue. Only keratinized tissue in the test group demonstrated a statistically significant greater increase compared to controls at the 6-month evaluation (P = 0.006). Conclusion: The use of EMD in conjunction with ADM resulted in a statistically significant effect on keratinized tissue increase, but no significant effects on probing attachment level or percentage of root surface coverage.
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