Clinical, Volumetric and Microcirculatory Outcomes of Multiple Gingival Recession Treatment with a Porcine Acellular Dermal Matrix: A Case Series

BACKGROUND: Recession Type 1 (RT1) multiple adjacent gingival recessions (MAGR) represent a clinically relevant condition and may compromise esthetics and function. Connective tissue grafts (CTG) remain the reference treatment but involve donor-site morbidity. Porcine acellular dermal matrices (PADM) have been proposed as substitutes. This prospective exploratory case series evaluated the clinical performance of the modified coronally advanced tunnel (MCAT) combined with a PADM, while also exploring microcirculatory behavior assessed by laser speckle contrast imaging (LSCI) and volumetric soft tissue changes. METHODS: Fifteen patients with 92 RT1 recession defects were treated using MCAT and a PADM (NovoMatrix®) in this prospective, single-center exploratory case series. The primary clinical outcome was site-level mean root coverage (MRC) at 6 months and 1 year, with recession sites clustered within patients. Key secondary outcomes were microcirculatory perfusion assessed by laser speckle contrast imaging (LSCI) in 53 sites, volumetric soft tissue change, and complete root coverage (CRC). RESULTS: At 6 months and 1 year, MRC was 73.2%, and CRC was achieved at 52.2% of sites. Recession depth and width decreased significantly (p < 0.001), while keratinized tissue width remained stable. Volumetric gain averaged 71.0 ± 37.4 mm³ at 6 months and 46.2 ± 23.5 mm³ at 1 year; values remained significantly above baseline at both time points, while volumetric gain decreased significantly from 6 months to 1 year (p < 0.001). Microcirculatory measurements showed an early reduction in perfusion followed by partial recovery over time, although some regions remained below baseline at later follow-up time points. Modest but significant site-level correlations were observed between day-30 perfusion and MRC at 6 months and 1 year. CONCLUSIONS: Within the limitations of this prospective exploratory case series, MCAT with PADM was associated with clinically relevant root coverage and supportive volumetric and microcirculatory findings in RT1 MAGRs.