Non-Cochrane · intervention · PM41752765
Comparative Effectiveness of Autogenous Connective Tissue Grafts and Xenogeneic Soft Tissue Substitutes for Multiple Gingival Recessions: A Systematic Review and Meta-Analysis.
Koppolu Pradeep, ElHaddad Sally Abd-ElMeniem, Abushama Azza A, et al. · Medicina (Kaunas, Lithuania) · 2026 · PubMed · doi:10.3390/medicina62020366
Findings
Population Patients with multiple gingival recessions (Miller Class I/II or Cairo RT1/RT2)
27 findings
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Keratinized tissue width (KTW) change, mm 6 months · Periodontal surgery for multiple gingival recessions | MD -0.33 [-0.69, 0.03] GRADE not reported 6 studies · 777 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Complete root coverage (CRC) 12 months · Periodontal surgery for multiple gingival recessions | RR 0.73 [0.46, 1.18] GRADE not reported 3 studies · 166 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Keratinized tissue width (KTW) change, mm 12 months · Periodontal surgery for multiple gingival recessions | MD -0.68 [-1.19, -0.17] GRADE not reported 7 studies · 372 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Mean root coverage (MRC, %) 6 months · Periodontal surgery for multiple gingival recessions | MD -13.4 [-15.32, -11.48] GRADE not reported 2 studies · 90 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Clinical attachment level (CAL) change, mm 12 months · Periodontal surgery for multiple gingival recessions · Sensitivity analysis: excluding McGuire 2010 | I2=17%; MD not reported; p=0.12 (non-significant) GRADE not reported 6 studies |
| Xenogeneic collagen matrix (XCM) with coronally advanced flap or tunnel technique | Autogenous connective tissue graft (CTG) with the same flap procedure | Gingival thickness change (mm) 6 months · Periodontal surgery (university, private practice and multicenter settings) · XCM at 6 months | MD -0.24 [-0.4, -0.08] GRADE not reported 1 study · 60 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Probing depth (PD) change, mm 12 months · Periodontal surgery for multiple gingival recessions · Sensitivity analysis: excluding McGuire 2010 | MD -0.29 [-0.39, -0.18] GRADE not reported 5 studies |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Probing depth (PD) change, mm 12 months · Periodontal surgery for multiple gingival recessions | MD -0.16 [-0.44, 0.11] GRADE not reported 6 studies · 332 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Complete root coverage (CRC) 6 months · Periodontal surgery for multiple gingival recessions | RR 0.71 [0.62, 0.82] GRADE not reported 3 studies · 607 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Clinical attachment level (CAL) change, mm 12 months · Periodontal surgery for multiple gingival recessions | MD 0.29 [0.02, 0.55] GRADE not reported 7 studies · 372 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Probing depth (PD) change, mm 6 months · Periodontal surgery for multiple gingival recessions | MD -0.08 [-0.25, 0.09] GRADE not reported 5 studies · 737 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Mean root coverage (MRC, %) 12 months · Periodontal surgery for multiple gingival recessions | MD -11.05 [-12.88, -9.23] GRADE not reported 3 studies · 130 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Clinical attachment level (CAL) change, mm 12 months · Periodontal surgery for multiple gingival recessions · Sensitivity analysis: excluding Elena 2024 | I2=32%; MD not reported; p<0.0001 (still significant favoring CTG) GRADE not reported 6 studies |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Gingival thickness (GT) change, mm 12 months · Periodontal surgery for multiple gingival recessions | MD -0.29 [-0.41, -0.18] GRADE not reported 3 studies · 144 participants |
| Flap procedure (CAF, tunnel or VISTA) with xenogeneic collagen matrix (XCM) | Same flap procedure with autogenous connective tissue graft (CTG) | Clinical attachment level (CAL) change, mm 6 months · Periodontal surgery for multiple gingival recessions | MD 0.4 [0.31, 0.49] GRADE not reported 5 studies · 292 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Mean root coverage (MRC, %) 12 months · Periodontal surgery for multiple gingival recessions | MD -11.63 [-15.92, -7.34] GRADE not reported 2 studies · 204 participants |
| Porcine xenogeneic acellular dermal matrix (P-XADM) with flap or tunnel technique | Autogenous connective tissue graft (CTG) with the same flap procedure | Mean root coverage (%) 6 months · Periodontal surgery (university, private practice and multicenter settings) · P-XADM at 6 months | MD -4.0 [-10.46, 2.46] GRADE not reported 1 study · 130 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Probing depth (PD) change, mm 12 months · Periodontal surgery for multiple gingival recessions | MD -0.01 [-0.08, 0.07] GRADE not reported 3 studies · 318 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Gingival thickness (GT) change, mm 12 months · Periodontal surgery for multiple gingival recessions | MD -0.25 [-0.53, 0.03] GRADE not reported 3 studies · 318 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Complete root coverage (CRC) 12 months · Periodontal surgery for multiple gingival recessions | RR 0.86 [0.72, 1.01] GRADE not reported 2 studies · 244 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Clinical attachment level (CAL) change, mm 12 months · Periodontal surgery for multiple gingival recessions | MD 0.3 [0.05, 0.54] GRADE not reported 3 studies · 318 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Clinical attachment level (CAL) change, mm 6 months · Periodontal surgery for multiple gingival recessions | MD 0.05 [-0.24, 0.33] GRADE not reported 5 studies · 384 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Probing depth (PD) change, mm 6 months · Periodontal surgery for multiple gingival recessions | MD 0.05 [-0.11, 0.2] GRADE not reported 4 studies · 356 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Gingival thickness (GT) change, mm 6 months · Periodontal surgery for multiple gingival recessions | MD -0.14 [-0.4, 0.11] GRADE not reported 2 studies · 244 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Keratinized tissue width (KTW) change, mm 6 months · Periodontal surgery for multiple gingival recessions | MD -0.11 [-0.26, 0.03] GRADE not reported 6 studies · 416 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Keratinized tissue width (KTW) change, mm 12 months · Periodontal surgery for multiple gingival recessions | MD -0.24 [-0.45, -0.02] GRADE not reported 3 studies · 318 participants |
| Flap procedure (CAF or tunnel) with porcine xenogeneic acellular dermal matrix (P-XADM) | Same flap procedure with autogenous connective tissue graft (CTG) | Complete root coverage (CRC) 6 months · Periodontal surgery for multiple gingival recessions | RR 0.82 [0.66, 1.02] GRADE not reported 5 studies · 384 participants |
Included primary studies 16
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Aroca 2013 Treatment of multiple adjacent Miller class I and II gingival recessions with a Modified Coronally Advanced Tunnel (MCAT) technique and a… PMID:23627374 | 2013 | 2 other reviews | not stated | not extracted yet |
| Meza-Mauricio 2021 Comparison between a xenogeneic dermal matrix and connective tissue graft for the treatment of multiple adjacent gingival recessions: a… PMID:34021404 | 2021 | 2 other reviews | not stated | not extracted yet |
| Pietruska 2019 Clinical evaluation of Miller class I and II recessions treatment with the use of modified coronally advanced tunnel technique with either… PMID:30362599 | 2019 | 2 other reviews | not stated | not extracted yet |
| Rakasevic 2020 The use of collagen porcine dermal matrix and connective tissue graft with modified coronally advanced tunnel technique in the treatment… PMID:32706184 | 2020 | 2 other reviews | not stated | not extracted yet |
| Cieslik-Wegemund 2016 Tunnel Technique With Collagen Matrix Compared With Connective Tissue Graft for Treatment of Periodontal Recession: A Randomized Clinical… PMID:27424564 | 2016 | 1 other review | not stated | not extracted yet |
| Elena 2024 Analysis of the treatment of RT2 recessions with a xenogeneic collagen matrix vs. connective tissue graft combined with a coronally… PMID:38489063 | 2024 | 1 other review | not stated | not extracted yet |
| Menezes 2024 Efficacy of xenogeneic collagen matrix in the treatment of gingival recessions: a controlled clinical trial. PMID:39536202 | 2024 | 1 other review | not stated | not extracted yet |
| Nahas 2020 Treatment of multiple recessions with collagen matrix versus connective tissue: a randomized clinical trial. PMID:31994596 | 2020 | 1 other review | not stated | not extracted yet |
| Tonetti 2017 Xenogenic collagen matrix or autologous connective tissue graft as adjunct to coronally advanced flaps for coverage of multiple adjacent… PMID:29087001 | 2018 | 1 other review | not stated | not extracted yet |
| Tonetti 2021 Autologous connective tissue graft or xenogenic collagen matrix with coronally advanced flaps for coverage of multiple adjacent gingival… PMID:33817812 | 2021 | 1 other review | not stated | not extracted yet |
| Gurlek 2020 Coronally advanced flap with connective tissue graft or xenogeneic acellular dermal matrix in the treatment of multiple gingival… PMID:31762155 | 2020 | this review only | not stated | not extracted yet |
| Harris 2024 Efficacy of Fibro-Gide® in coronally advanced flap for the treatment of multiple gingival recession: A prospective clinical study DOI:10.4103/jioh.jioh_120_23 | 2024 | this review only | not stated | not extracted yet |
| Maluta 2021 Root coverage of multiple gingival recessions treated with coronally advanced flap associated with xenogeneic acellular dermal matrix or… PMID:33723662 | 2021 | this review only | not stated | not extracted yet |
| McGuire 2010 Xenogeneic collagen matrix with coronally advanced flap compared to connective tissue with coronally advanced flap for the treatment of… PMID:20350159 | 2010 | this review only | not stated | not extracted yet |
| Suzuki 2020 Root coverage using coronally advanced flap with porcine-derived acellular dermal matrix or subepithelial connective tissue graft: a… PMID:32382931 | 2020 | this review only | not stated | not extracted yet |
| Vincent-Bugnas 2021 Treatment of multiple gingival recessions with xenogeneic acellular dermal matrix compared to connective tissue graft: a randomized… PMID:33913631 | 2021 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with multiple gingival recessions (Miller Class I/II or Cairo RT1/RT2) | 632 patients with 1878 recessions (Miller Class I/II or Cairo RT1/RT2) (n=16 RCTs) |
| Intervention | Coronally advanced flap, tunneling technique or VISTA with a xenogeneic soft tissue substitute (collagen matrix XCM or acellular dermal matrix XADM) | XCM (Mucograft, Fibro-Gide, Mucoderm) (n=9 studies); P-XADM (Mucoderm) (n=7 studies) with CAF, modified CAF, tunnel technique or eCPF |
| Comparison | Same flap procedure with autogenous connective tissue graft (CTG) | Autogenous connective tissue graft with the same flap |
| Outcomes | Primary: mean root coverage, complete root coverage. Secondary: keratinized tissue width, gingival thickness, probing depth, clinical attachment level | Complete root coverage, mean root coverage, clinical attachment level, keratinized tissue width, gingival thickness, probing depth |
| Study designs | English RCTs | 16 RCTs (split-mouth and parallel) |
| Timing | Follow-up at 6 and 12 months | 3 to 36 months follow-up; pooled at 6 and 12 months |