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. 2022 Jan 19;8:20595131211038313. doi: 10.1177/20595131211038313

Table 7.

Clinical evidence for ADM in oral and maxillofacial surgery.

Authors Product name(s), Material Usage, Population Summary findings
(A) Gingival recessions
Case series and case reports
Fickl et al. (2013) Unspecified PADM 6 patients with 28 gingival recessions had a procedure with a modified tunnelling technique and ADM

  • At 6 months postoperatively, mean root coverage was 65.52%

  • At 12 months postoperatively, mean root coverage was 56.82%

  • Complete root coverage was achieved in 42.86% of the treated gingival recessions
Prospective studies
Godavsarthi et al. (2016) AlloDerm®,
HADM		 14 patients with Miller Class I or II gingival recessions 3 women Mean age: 41.4 years Randomly assigned to PPG with CAF or ADM with CAF

  • Mean recession depth in PPG/CAF decreased from 2.89 ± 0.40 mm at baseline to 0.25 ± 0.50 mm at 12 months with a mean root coverage of 92.79% ± 14.25%

  • Mean recession depth in ADM/CAF decreased from 2.93 ± 0.55 mm at baseline to 0.32 ± 0.46 mm at 12 months with a mean root coverage of 89.79% ± 14.73%

  • PPG/CAF was found to have a perceived improvement in aesthetics
Abou-Arraj et al. (2017) AlloDerm®,
HADM

Puros Dermis®
Solvent-dehydrated HADM		 17 patients with Miller Class I gingival recessions
Randomly assigned to AlloDerm® or Puros Dermis® groups

  • Both groups had predictable and sufficient root coverage

  • A zone of immobile connective tissue extending to the mucogingival junction was created
Cosgarea et al. (2016) Mucoderm®,
PADM		 12 patients with at least two Miller Class I, II or III gingival recessions treated with a modified coronally advanced tunnel technique and then with an ADM
9 women, mean age: 34 years

  • Found significant improvements in 98.15% of gingival recessions with a 2.06 ± 1.18 mm reduction

  • Mean root coverage was 73.20% ± 27.71%

  • No significant changes in periodontal pocket depth
Chaparro et al. (2015) Unspecified PADM 24 patients with 93 gingival recessions were treated with the tunnel procedure and ADM

  • 100% root coverage in 68% of maxillary recessions and 53% of mandibular recessions

  • In partial root coverage, the recession went from a mean of 4.41 to 0.83 mm in the maxilla and 3.78 to 0.78 mm in the mandible

  • Root coverage of 100% was observed in 74.07% of Miller Class I recessions in comparison with 43.59% of Class II recessions (P = 0.003)
Costa et al. (2016) AlloDerm®,
HADM		 19 smokers with bilateral Miller Class I or II gingival recessions were randomly assigned to received ADM and EMD or ADM alone

  • Mean gain in recession height (P < 0.05) and sites with complete root coverage (P < 0.05) were better in the ADM/EMD group

  • Percentage of root coverage was 60% in the ADM/EMD group and 53% in ADM alone
Mahn et al. (2015) AlloDerm®,
HADM		 50 patients with Class I and II gingival recessions were treated with an ADM with a CAF

  • At 52 weeks, the average recession decreased from 3.8 ± 0.9 mm to 0.2 ± 0.5 mm

  • There was 94.7% root coverage

  • Complete root coverage achieved in 80% of cases
Ozenci et al. (2015) AlloDerm®,
HADM		 20 patients with 58 Miller Class I gingival recessions were divided into receiving either ADM with tunnel technique or ADM with CAF

  • Mean root coverage was 75.72% in TUN/ADM and 93.81% in CAF/ADM

  • CAF/ADM performed significantly better in probing depth, clinical attachment level, recession height and width, keratinised tissue height, gingival thickness and complete/mean root coverage (P < 0.05)
Wang et al. (2015) AlloDerm®,
HADM Puros Dermis®,
Solvent-dehydrated HADM		 20 patients with Miller Class I and II gingival recessions were treated with either FDADM or SDADM

  • At 12 months, a mean improvement in attachment level of 2.0 ± 1.08 mm for FDADM and 2.0 ± 0.70 mm for both SDADM was achieved (P = 0.002)

  • Root coverage after 12 months was 80.66 ± 22.90% for FDADM and 80.97 ± 18.08% for SDADM
De Resende et al. (2019) AlloDerm®,
HADM		 25 patients with 50 recession sites were treated with either a FGG or ADM

  • Probing depth and clinical attachment level showed no significant differences

  • Professionals thought the aesthetics were better in the ADM group

  • Tissue thickness was inferior for ADM vs. FGG

  • Histomorphometric analysis demonstrated higher percentage of cellularity, blood vessels and epithelial luminal to basal surface ratio for FGG group

  • ADM had a higher percentage of collagen fibres and inflammatory infiltrate
(B) Gingival fenestration
Case series and case reports
Breault et al. (2016) AlloDerm®,
HADM		 ADM used to treat one gingival fenestration

  • At 2.5 months, ADM was integrated into the soft tissue with complete resolution of gingival fenestration

  • Excellent aesthetics
(C) Parotid fistula
Case studies
Blythe et al. (2016) AlloDerm®,
HADM		 One patient with a parotid fistula

  • A parotid fistula was successfully treated with ADM
(D) Alveolar bone grafts
Retrospective studies
Clavijo-Alvarez et al. (2010) AlloDerm®,
HADM		 35 patients included from a retrospective review from 2005 to 2007 15 patients (4 girls) received ADM augmentation Mean age at surgery was 10 years

  • No significant difference in mucosal disruption between the two groups or complete mucosal healing time (average of 4 weeks)

  • Exposure of bone graft occurred in 0% of the ADM group and in 30% of the control group (P = 0.016)

  • No significant difference in postoperative bone graft incorporation according to the Chelsea scale

  • No significant difference in canine eruption through graft site
(E) Regenerate bone/soft tissue in dental implants
Case studies and case series
Momen-Heravi et al. (2018) PerioDerm®,
HADM		 A patient with a successful soft-tissue and bone regeneration of dehiscence in the maxillary incisor region using ADM

  • There was >95% new bone formation at implant surface 5 months after soft-tissue and bone augmentation
Prospective studies
Fischer et al. (2019) Derma®,
PADM		 20 patients undergoing implant surgery with soft-tissue augmentation (24 total cases) with ADM
Mean age: 50.2 ± 11.9 years

  • At 6-month follow-up, there was a mean dimensional gain of 0.83 ± 0.64 mm (P < 0.01)

  • Soft-tissue shrinkage on average was averaged 34.2% ± 77.0% from T2 to T3 (P < 0.01) and did not change (p = 0.39)

  • No adverse events
Papi and Pompa (2018) Mucoderm®,
PADM		 12 patients received a dental implant in the upper premolar area and the ADM was inserted 8 weeks later

  • One month after insertion of the ADM, mean KMW was .86 ± 3.22 mm At 1 year after insertion, mean KMW was 5.67 ± 2.12 mm

  • No complications with wound healing occurred
Fernandes et al. (2016) AlloDerm®,
HADM		 19 patients undergoing extraction of maxillary teeth were randomly assigned to ADM and mineralised AB or ADM only

  • ADM/AB showed reduced bone loss after 6–8 months (P < 0.01)

  • ADM/AB showed a higher percentage of mineralised tissue and lower percentage of non-mineralised tissue (P > 0.05)

  • ADM/AB had reduced alveolar bone loss after 6–8 months
(F) Repair ora-antral fistulas
Prospective studies
Li et al. (2018) Heal-all®,
HADM		 9 patients with oro-antral fistulas had the defects repaired with ADM and acellular bone matrix

  • At 6 months postoperatively, the fistulas were well healed; no nasal congestion or runny noses

  • Computed tomography confirmed wound healing

AB, bone allograft; ADM, acellular dermal matrix; CAF, coronally advanced flap; EMD, enamel matrix derivative; FDADM, freeze-dried ADM; FGG, free gingival graft; HADM, human acellular dermal matrix; KMW, keratinised mucosa width; PADM, porcine acellular dermal matrix; PPG, periosteal pedicle graft; SDADM, solvent-dehydrated ADM.