Free gingival graft and acellular dermal matrix for gingival augmentation: a 15-year clinical study

  • Cecilia Amparo Reyes CevallosEmail author
  • Daniel Romeu Benchimol de Resende
  • Carla Andreotti Damante
  • Adriana Campos Passanezi Sant’Ana
  • Maria Lúcia Rubo de Rezende
  • Sebastião Luiz Aguiar Greghi
  • Mariana Schutzer Ragghianti Zangrando
Original Article



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).


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.


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.


Mucogingival surgery Grafts Acellular dermal Gingiva Postoperative period 



This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Brasil (CAPES)-Finance code 001. Part of this study was supported by a grant (no. 99/09834-2) from FAPESP (São Paulo Research Foundation). The work was financially supported by the Department of Prosthodontics and Periodontics of Bauru School of Dentistry, University of São Paulo, Brazil.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Cecilia Amparo Reyes Cevallos
    • 1
    Email author
  • Daniel Romeu Benchimol de Resende
    • 2
  • Carla Andreotti Damante
    • 1
  • Adriana Campos Passanezi Sant’Ana
    • 1
  • Maria Lúcia Rubo de Rezende
    • 1
  • Sebastião Luiz Aguiar Greghi
    • 1
  • Mariana Schutzer Ragghianti Zangrando
    • 1
  1. 1.Department of Prosthodontics and Periodontics, Bauru School of DentistryUniversity of Sao PauloBauruBrazil
  2. 2.BauruBrazil

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