Achievement of root coverage in advanced gingival recession defects involving multiple mandibular anterior teeth is often challenging. Long-term outcomes of xenogeneic collagen matrices and their effectiveness in comparison to connective tissue grafts need to be explored. Aim: To assess and compare the long-term outcomes of xenogenic collagen matrix or connective tissue grafts in conjunction with the modified mucogingival flap procedure (MMGF) in the treatment of multiple mandibular gingival

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... ession defects. Materials and Methods: 38 systemically healthy patients presenting with multiple mandibular Miller's class III gingival recession were treated using MMGF along with either connective tissue graft (n=20) or xenogenic collagen matrix(n=18). Subjects were followed up for 3 years post intervention. At the end of 3yrs, 30 subjects were examined for assessment of the changes in recession height (RH), keratinized tissue width (KT), attached gingiva (AG), relative vestibular depth (RVD) and root coverage percentage (RC%). Results: Statistically significant improvement in all clinical parameters were noted in both test and control subjects at the end of 1 and 3 years (p< 0.05). MMGF + CTG treated sites demonstrated a significantly greater RC% of 67.10 ± 22.90% than MMGF +XCM sites (35.51 ± 16.14% ) at the end of 3 years (p<0.05). Conclusion: Xenogenic collagen matrix along with MMGF yielded short term improvement in terms of root coverage than when compared to the connective tissue graft while treating advanced multiple recession defects.