OBJECTIVES This study evaluated clinical outcomes of acellular dermal matrix (ADM) allograft compared with autogenous free gingival graft (FGG) for gingival augmentation after 15 years. MATERIAL AND METHODS Twenty-two patients were originally included and evaluated by de Resende et al. (Clin Oral Investig 23:539-550, 2019), and 12 accepted to participate in this longitudinal evaluation. Clinical parameters evaluated were recession depth (RD), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), and soft tissue thickness (TT). In addition, esthetic perception was evaluated by patients and by a calibrated periodontist. Data were evaluated by ANOVA complemented by Tukey tests (p < 0.05). RESULTS After 15 years, both treatments provided a significant increase in KTW and TT but with superior results for the FGG group (p < 0.05). No differences were observed between groups for PD and CAL. In the ADM group, RD significantly increased in long term, as well as the rate of tissue contraction. The percentage of shrinkage for the ADM group was 59.6%. Conversely, the FGG group presented a creeping attachment of 17.6% and RD significantly decreased in long term. The ADM group presented superior results considering professional esthetic perception. CONCLUSIONS Both treatments longitudinally promoted significant gain of keratinized tissue width and thickness with superior outcomes for the FGG group. The ADM group demonstrated more tissue contraction and gingival recession whereas the FGG group presented creeping attachment. Professional esthetic perception was superior for the ADM group. CLINICAL RELEVANCE This study added important clinical data with long-term evaluation of ADM compared with FGG.

中文翻译：

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游离牙龈移植物和脱细胞真皮基质用于牙龈增强：15年的临床研究。

目的本研究评估了同种异体脱细胞真皮基质（ADM）与自体游离牙龈移植物（FGG）进行15年后牙龈增生的临床效果。材料和方法22位患者最初被纳入研究，并由de Resende等人评估。（Clin Oral Investig 23：539-550，2019），并且接受了12人参与此纵向评估。评估的临床参数是后退深度（RD），探测深度（PD），临床附着水平（CAL），角化组织宽度（KTW）和软组织厚度（TT）。此外，患者和经过校准的牙周病医师还评估了审美感知。数据通过ANOVA评估和Tukey检验进行补充（p <0.05）。结果15年后，两种治疗均使KTW和TT显着增加，但FGG组的结果更好（p <0.05）。PD和CAL组之间未观察到差异。在ADM组中，RD的长期升高以及组织收缩的速率均显着增加。ADM组的收缩百分比为59.6％。相反，FGG组表现出17.6％的蠕变依恋，长期来看RD显着降低。考虑到专业的审美观，ADM组提出了更好的结果。结论两种治疗方法均可纵向促进角质化组织宽度和厚度的明显增加，而FGG组的效果更好。ADM组表现出更多的组织收缩和牙龈退缩，而FGG组表现出蠕动附着。专业审美观对于ADM组而言更为出色。临床相关性这项研究为ADM和FGG的长期评估提供了重要的临床数据。