Gingival recession coverage: Do we still need autogenous grafts?

A variety of periodontal plastic surgical techniques have been proposed to obtain root coverage of gingival recession defects. All of the available root coverage procedures are able to provide significant root coverage for Miller Class I and II recession-type defects. However, only the subepithelial connective tissue graft in conjunction with a coronally advanced flap appears consistently effective across all clinical parameters, and is therefore currently considered the gold standard for gingival recession therapy. The major shortcomings of connective tissue graft procedures include patient morbidity associated with the second surgical site and limited availability of palatal donor tissue. More recently, 3D collagen matrices of human and porcine origin have been introduced as possible alternatives to autogenous connective tissue grafts in recession coverage procedures. This paper aims to give an overview on the possible use of collagen matrices as soft tissue substitutes and a possible alternative to connective tissue grafts in the surgical treatment of gingival recession defects.