Polynucleotides and Hyaluronic Acid Mixture with Volume Stable Collagen Matrix for Coverage of Multiple Gingival Recession: A Case Series

Multiple adjacent gingival recessions are a challenge to the practitioner. Although the gold standard is still the bilaminar technique, where a coronally advanced flap (CAF) is associated with autogenous connective tissue graft (CTG), the morbidity of the procedure may lead clinicians to look for CTG substitutes. In this study, a prospective case series, 16 patients presenting multiple adjacent gingival recession were treated using CAF plus a volume stable collagen matrix (VXCM) soaked with a gel made of polynucleotides and hyaluronic acid (PNHA). Clinical measurements (probing depth, recession, attachment level, keratinised mucosa) were performed at baseline (T0), six months (T1) and twelve months (T2) post-operatively. Change in gingival thickness (dGT) was also measured using intraolar scans at T0 and T2, together with secondary variables, such as wound healing indices, patient-reported outcomes (pain, esthetics), and adverse events. Statistical analysis has been performed, setting significance with p<0.05. At one year evaluation, mean recession depth decreased of 2.42 ± 0.45, the percentage of root coverage was 96.02 + 0.09% (80.59% complete root coverage) , while gingival thickness dGT increased by 1.14 ± 0.34 mm, indicating that VXCM and PN-HA plus CAF are a suitable option for the treatment of multiple adjacent gingival recessions.