Long-Term Outcomes of Collagen Matrix versus Subepithelial Connective Tissue in Root Coverage for Multiple Teeth: A Systematic Review and Meta-Analysis

Background: This study aimed to conduct a meta-analysis to assess the differences in the performance of root coverage between collagen matrix and subepithelial connective tissue. Methods: A comprehensive search using a combination of controlled vocabulary (MeSH) and free-text terms was undertaken by two reviewers to identify published systematic reviews. Three major electronic databases (Medline via PubMed, Cochrane database, and Embase) were searched up to October 2023. Results: Initially, five hundred and seventy-six articles were identified, but only nine studies met the criteria for inclusion in the meta-analysis. Meta-analysis showed that the pooled mean difference in mean root coverage of collagen matrix compared with subepithelial connective tissue was −0.48 (95% confidence interval of −0.69 to −0.26). The relative risk of complete root coverage of collagen matrix compared with subepithelial connective tissue was 0.68 (95% confidence interval, 0.49 to 0.94). The pooled mean difference in width of keratinized tissue of collagen matrix compared with subepithelial connective tissue was −0.75 (95% confidence interval of −1.25 to −0.26). Conclusions: The outcomes of this study revealed that subepithelial connective tissue generally exhibited superior performance. Nonetheless, the utilization of the coronally advanced flap with collagen matrix may yield comparable results in terms of the percentage of complete root coverage.