Comparison of Tissue Substitutes with Subepithelial Connective Tissue Graft by Tunnel or Modified Technique in Root Coverage: A Systematic Review

Abstract

To evaluate the efficacy of soft tissue substitutes, namely acellular dermal matrix (ADM), collagen matrix (CM), and titanium-prepared platelet-rich fibrin (T-PRF) in comparison to subepithelial connective tissue graft (SECTG) by tunnel or modified coronally advanced tunnel technique (MCAT) in root coverage. A literature search on MEDLINE, PubMed, Cochrane Libraries, Embase and hand-searched journals were covered from January 1999 to August 2020, which investigated the efficacy of soft tissue substitutes in comparison to SECTG by tunnel technique (TUN) orMCAT for root coverage procedures. Only randomized control trials (RCTs) were considered. Seven studies were included for qualitative synthesis. SECTG, ADM and T-PRF were more effective for complete/partial root coverage (CRC) which was considered as the primary outcome according to Miller’s classification. SECTG showed better results when secondary outcomes were considered. The clinical efficacy of SECTG seemed to be higher in tunnel or MCAT for root coverage. Hence, SECTG can be a better option compared to other substitutes.