Effectiveness of Amniotic Membrane with Coronally Advanced Flap in the Treatment of Gingival Recession in Adult Patients: A Systematic Review

To evaluate the effectiveness of amnion membrane on the clinical parameters when used in the treatment of Millers Class I and Class II gingival recession in chronic periodontitis patients along with coronally advanced flap (CAF). Data resources: Four databases MEDLINE (by PubMed), Cochrane database, EBSCO, and Google Scholar were explored to identify the studies in English up to April 2020. An additional hand search of relevant journals was also done. Two independent reviewers screened the retrieved articles using the particular inclusion criteria. Randomized control trials (RCTs) evaluating the effectiveness of amnion membrane with CAF in treatment of Millers Class I and Class II gingival recession in chronic periodontitis patients were included in the study. Outcome variables examined were recession width (RW), recession depth (RD), clinical attachment level (CAL), keratinized width of gingiva (KWG), probing pocket depth (PD), and gingival thickness (GT). Data were analyzed using Revman5.3 software. The mean differences and 95% confidence interval were used to illustrate the estimate of effect size. Study selection: Seven relevant articles were recognized for data procurement. One hundred and twenty patients with 244 gingival recession sites in total with an age range between 18 years and 55 years of participants were selected. There is an equal effect in both the groups for the RD reduction. For RW reduction, the result was in the favor of amnion membrane with CAF group, whereas for CAL gain, PD reduction, KWG gain, and GT gain results favored the different biomaterial other than amnion membrane but no statistical significant difference was found. Conclusion: Within the limitation of the study, it seems that the amnion membrane can be used successfully along with CAF to treat the gingival recession.