Efficacy of Human Chorion Membrane Allograft for Recession Coverage: A Case Series.

BACKGROUND Membranes of human placentas have been used in the field of medicine for skin grafts, treatment of burns, and ulcerated skin conditions with great success. The use of placenta allografts in dentistry is a more recent development, with the first commercial product being made available in 2008. The unique inherent biologic properties in placenta allografts enhance wound healing and may propagate regeneration. METHODS Ten healthy adult patients presenting with 21 Miller Class I gingival recession (GR) defects (isolated or adjacent multiple) were surgically treated with a modified coronally advanced flap and chorion membrane for root coverage. Clinical parameters measured at baseline, 3 months, and 6 months were probing depth, clinical attachment level, GR height, width of keratinized gingiva, and assessment of gingival biotype. Statistical analysis was performed to compare the treatment outcomes at the follow-up intervals. RESULTS The results showed statistically significant (P <0.001) improvements in all clinical parameters at the 3- and 6-month follow-ups. The mean percentage of root coverage at the end of 6 months was 89.92% ± 15.59%, and 14 of 21 treated GR defects showed 100% root coverage. The gingival biotype also showed a thick biotype in nine sites that had an initial thin biotype. CONCLUSIONS Fetal membranes possess distinctive properties that can be harnessed to promote periodontal healing. The chorion membrane covered by a modified coronally advanced flap is a new approach that has shown promising results in terms of root coverage, increased width of keratinized tissue, and thickness of the gingival biotype.

[1]  D. Suresh,et al.  Gingival Biotype Enhancement and Root Coverage Using Human Placental Chorion Membrane , 2013 .

[2]  Dan J Holtzclaw,et al.  Amnion-Chorion Allograft Barrier Used for Guided Tissue Regeneration Treatment of Periodontal Intrabony Defects: A Retrospective Observational Report , 2013 .

[3]  A. Seifalian,et al.  Properties of the amniotic membrane for potential use in tissue engineering. , 2008, European cells & materials.

[4]  J. Wennström,et al.  Mucogingival therapy - Periodontal Plastic Surgery , 2008 .

[5]  G. Zucchelli,et al.  Coronally advanced flap: a modified surgical approach for isolated recession-type defects: three-year results. , 2007, Journal of clinical periodontology.

[6]  M. Paolantonio,et al.  Root coverage with a coronally positioned flap used in combination with enamel matrix derivative: 18-month clinical evaluation. , 2006, Journal of periodontology.

[7]  M. Ryan Nonsurgical approaches for the treatment of periodontal diseases. , 2005, Dental clinics of North America.

[8]  Kitichai Rungcharassaeng,et al.  Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans. , 2003, Journal of periodontology.

[9]  N. Koizumi,et al.  Growth factor mRNA and protein in preserved human amniotic membrane , 2000 .

[10]  H. Löe,et al.  The natural history of periodontal disease in man: prevalence, severity, and extent of gingival recession. , 1992, Journal of periodontology.

[11]  P. Miller,et al.  Coronal positioning of existing gingiva: short term results in the treatment of shallow marginal tissue recession. , 1989, Journal of periodontology.

[12]  P. Miller,et al.  Coronal positioning of existing gingiva: short term results in the treatment of shallow marginal tissue recession. , 1989, Journal of periodontology.

[13]  A. Steinberg,et al.  Extravascular clot formation and platelet activation on variously treated root surfaces. , 1986, Journal of periodontology.

[14]  W. E. Wright,et al.  Basic Biological Sciences , 1980 .

[15]  W. E. Wright,et al.  Demonstration of fibronectin as a major extracellular protein of human gingival fibroblasts. , 1980, Journal of dental research.

[16]  G. Bourne The foetal membranes. A review of the anatomy of normal amnion and chorion and some aspects of their function. , 1962, Postgraduate medical journal.