• Baseline situation
Mario Taba Jr
Dr. Mario Taba Jr
Brazil

Study

Ten-year follow-up of bilateral gingival recession treatment: A case report

https://pubmed.ncbi.nlm.nih.gov/41870313/
Luiz C. L. Marques-Junior, Milena S. Irie, Edgar Daniel Vargas-Quiroga,  Mario Taba-Jr, Atila V. V. Nobre

Marques-Junior LCL, Irie MS, Vargas-Quiroga ED, Taba-Jr M, Nobre AVV. Ten-year follow-up of bilateral gingival recession treatment: A case report. Clin Adv Periodontics. 2026;1-7. https://doi.org/10.1002/cap.70059

INTRODUCTION

Gingival recession (GR) is a highly prevalent condition characterized by apical displacement of the gingival margin, leading to root exposure and associated with hypersensitivity, aesthetic concerns, and increased risk of root caries. While the coronally advanced flap (CAF) combined with subepithelial connective tissue graft (SCTG) remains the gold standard in root coverage procedures, it is associated with donor-site morbidity, limited tissue availability, and increased surgical complexity. To address these limitations, biomaterials such as xenogeneic collagen matrices (CM) and enamel matrix derivative (EMD) have been introduced to support soft tissue regeneration. This case report presents the treatment of bilateral Cairo RT1 gingival recessions in the maxillary canines of a young, healthy patient using the acellular dermal matrix mucoderm® in combination with EMD with a 10-year follow-up.

A 25-year-old healthy, non-smoking female patient presented with dentin hypersensitivity and aesthetic concerns. Clinical examination revealed bilateral RT1 gingival recessions on maxillary canines (#6 and #11), with no interproximal attachment loss or bone loss. The patient had good oral hygiene and a history of orthodontic treatment. A treatment plan of CAF + mucoderm® + EMD (Emdogain, Straumann) was selected. Outcomes were assessed at baseline, 12 months, and 10 years. Gingival thickness was measured at 10-year follow-up using transgingival probing.

SURGICAL PROCEDURE

Local anesthesia was administered using 4% articaine with epinephrine. A split-thickness flap was then elevated on the buccal aspect of the maxillary canines, allowing adequate mobilization of the soft tissues. The exposed root surfaces were thoroughly scaled and root planed, followed by conditioning with EDTA gel for 2 minutes and copious saline irrigation. mucoderm® was hydrated, trimmed to fit the defect, and stabilized over the root surface using absorbable sutures. Subsequently, EMD was applied as a biologically active adjunct, either directly onto the root surface prior to matrix placement and/or at the interface between the matrix and the flap, depending on the site. The flap was then coronally advanced to a position 1–2 mm above the cementoenamel junction and secured using sutures to ensure stability.

RESULTS

  • At the 12-month and 10-year follow-ups, recession depth and width were 0 mm on both teeth, corresponding to 100% root coverage at both time points.
  • Keratinized tissue height increased from 1 mm (tooth #6) and 2 mm (tooth #11) at baseline to 3 mm at 12 months and remained 3 mm after 10 years.
  • Probing depth remained stable at 1 mm
  • Gingival thickness at 10 years: ~0.83–0.85 mm

Clinically and photographically, outcomes were stable over 10 years with no recurrence of recession. The patient reported high aesthetic satisfaction and no hypersensitivity.

CONCLUSIONS

The procedure with mucoderm® and EMD for the treatment of gingival recessions:

  • Enabled 100% root coverage at both 12 months and maintained stability over a 10-year follow-up.
  • Contributed to an increased keratinized tissue height (from 1–2 mm to 3 mm), supporting improved soft tissue quality.
  • Was associated with reduced patient morbidity, it eliminates donor-site complications such as pain, bleeding, and limited tissue availability.
  • Demonstrated excellent aesthetic outcomes, with high patient satisfaction reported even after 10 years.

These findings reinforce the long-term efficacy and safety of the combined use of mucoderm® and EMD for the treatment of gingival recessions.

Read the full publication and explore the long-term success behind this case.

Baseline situation
Right canine at baseline
Left canine at baseline
Clinical and surgical sequence at tooth #6: initial baseline condition, surgical incisions made, flap release assessment following split-thickness flap preparation, exposure of the root surface, application of ethylenediaminetetraacetic acid (EDTA), placement of enamel matrix derivative (EMD) on the root surface, positioning and stabilization of the matrix, further application of EMD between the matrix and the flap, and immediate postoperative appearance.
Follow-ups. postoperative at 7 days, showing proper stabilization of the coronally advanced flap using 5-0 nylon sutures and mild inflammatory appearance
postoperative at 30 days, demonstrating tissue maturation, increased gingival thickness, and signs of keratinization
postoperative at 30 days, demonstrating tissue maturation, increased gingival thickness, and signs of keratinization; postoperative at 18 months, showing complete root coverage, stable keratinized tissue with adequate height and thickness, and absence of inflammation
Postoperative at 10 years, exhibiting long-term clinical stability, preservation of root coverage, and maintenance of keratinized gingiva volume with no recurrence of recession or tissue retraction
Clinical situation at baseline: (a), (b), and (c); and at 10 years follow-up (d), (e), and (f).
Close-up intraoral views of maxillary canines with bilateral gingival recession and exposed root surfaces, showing mucoderm® and Emdogain by Straumann.

Soft tissue managementmucoderm®

Also interesting

Academy

0
Surgeries
0
Webinars
0
Specialists