الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Gingival recession is a common condition usually encountered in our daily practice, and it is one of the various periodontal problems that can give rise to both esthetic & functional complaints. Several etiologic factors can play a role in the formation of gingival recession defects, and it is considered as one of the most prevalent diseases.
There are multiple treatment options that were proposed in the treatment of gingival recession depending on the patient’s chief complaint, the treatment can be non-surgical or surgical treatment. Multiple surgical techniques have been proposed in the treatment of gingival recession defects, one of the most commonly used surgical techniques is the tunneling technique which may be associated with grafting materials.
Multiple graft materials have been proposed in the treatment process, the most commonly used graft for the treatment of gingival recession is the connective tissue graft being considered as the gold standard, owing to its ability to achieve complete root coverage along with better stability of the gingival margin and the creeping attachment phenomenon.
Multiple replacement grafts have been proposed to avoid the second surgical site and the patient morbidity following the harvesting procedures of the autogenous graft that are of natural cadaveric origin, xenogeneic collagen membrane and human growth factors. Xenogeneic acellular dermal matrix is a collagen matrix originating from porcine dermis acting as a scaffold for proliferating cells allowing for its vascularization.
This study was conducted on sixteen patients having Miller class I & II gingival recession. The patients were allocated to two groups, group (I)
included eight patients that were treated with the tunneling technique in conjunction with xenogeneic acellular dermal matrix, group (II) included eight patients treated with the tunneling technique in conjunction with connective tissue graft. The clinical parameters measured for the patients at 3 and 6 months are: probing depth, clinical attachment level, gingival recession depth, gingival recession width, keratinized tissue width and the root coverage esthetic score. Other parameters that were included in the study are the mean root coverage percentage and the completer root coverage percentage.
Volumetric analysis was done to assess the gingival thickness alterations following surgical treatment where impressions were made at baseline and 6 months, the impressions were poured into casts and scanned into STL files. The STL files were imported into a software that was used to superimpose the pre and post scans of the study models by utilizing three or more fixed points on the teeth surface such as the incisal edges or cusp tips, and match the virtual models in one coordinate system. Fine tuning using manual tools was used to achieve proper alignment of the STL files. The alteration in the gingival thickness (mm) were calculated in the midsection of the tooth by digital subtraction of the difference in gingival thickness before and after the surgical intervention.
The results of the study showed marked Improvement in the clinical parameters when compared with baseline conditions in both groups, with both grafts being efficient in root coverage procedures showing marked clinical improve with the connective tissue graft showing slightly better results concerning root coverage and root coverage esthetic score but with no clinical significance difference. The xenogeneic acellular dermal matrix showed improvement in all clinical parameters deeming it viable to be used as an alternative to connective tissue graft in gingival recession defects treatment
and to avoid the second surgical site with all its possible complications and the patient morbidity associated with that.