Borghetti A, Glise J M, Monnet-Corti V, Dejou J
Faculté d'Odontologie, Université de la Méditerranée, Marseille, France.
J Periodontol. 1999 Feb;70(2):123-30. doi: 10.1902/jop.1999.70.2.123.
Connective tissue grafts and guided tissue regeneration (GTR) are the most current procedures in the treatment of gingival recession, but very few clinical comparative studies have been conducted.
The purpose of this study was to compare 2 types of treatment of gingival recession in the same patients. Fourteen pairs of Miller Class I defects were selected in 14 patients. In each pair, one recession was randomly assigned for treatment by GTR using a bioabsorbable membrane, and the other treated by subepithelial connective tissue graft (CTG). Height of recession (HR), clinical attachment level (CAL), probing sulcus depth (PSD), height of keratinized tissue (HKT), and distance from the cemento-enamel junction to the mucogingival junction (CEJ-MGJ) were recorded before surgery and 6 months postoperatively.
The initial width and height of recession were, respectively, 3.73 mm (SD 0.56) and 3.85 mm (SD 1.15) for the CTG group, and 4.04 mm (SD 0.92) and 4.28 mm (SD 1.20) for the GTR group. The differences were not significant. CAL changes were not different. Both in the CTG group and in the GTR group, mean HR reduction was 2.89 mm (SD 1.18), representing a mean root coverage of 76% and 70.2%, respectively. The difference was not significant. HKT mean gain was significantly greater (P = 0.0001) with CTG (2.03 mm, SD 0.92) than with GTR (0.42 mm, SD 0.91). The GTR technique displaced the mucogingival junction significantly (P = 0.007) more coronally (2.35 mm, SD 1.44) than the CTG technique (0.78 mm, SD 1.23).
Within the limits of this study, no difference could be found between subepithelial connective tissue graft and GTR with a bioabsorbable membrane with regard to root coverage, but the GTR technique did not increase the height of keratinized tissue and displaced the mucogingival junction more coronally at 6 months.
结缔组织移植和引导组织再生（GTR）是目前治疗牙龈退缩的常用方法，但很少有临床对比研究。
本研究旨在比较同一患者的两种牙龈退缩治疗方法。在14名患者中选择了14对米勒I类缺损。在每一对中，随机选择一处退缩采用生物可吸收膜通过GTR进行治疗，另一处采用上皮下结缔组织移植（CTG）治疗。记录术前及术后6个月时的退缩高度（HR）、临床附着水平（CAL）、探诊沟深度（PSD）、角化组织高度（HKT）以及从牙骨质-釉质界到龈黏膜联合处的距离（CEJ-MGJ）。
CTG组退缩的初始宽度和高度分别为3.73 mm（标准差0.56）和3.85 mm（标准差1.15），GTR组分别为4.04 mm（标准差0.92）和4.28 mm（标准差1.20）。差异无统计学意义。CAL变化无差异。CTG组和GTR组的平均HR降低均为2.89 mm（标准差1.18），分别代表平均牙根覆盖率为76%和70.2%。差异无统计学意义。CTG组的HKT平均增加量（2.03 mm，标准差0.92）显著大于GTR组（0.42 mm，标准差0.91）（P = 0.0001）。GTR技术使龈黏膜联合处向冠方移位（2.35 mm，标准差1.44）显著大于CTG技术（0.78 mm,标准差1.23）(P = 0.007)。
在本研究范围内，上皮下结缔组织移植与使用生物可吸收膜的GTR在牙根覆盖方面无差异，但GTR技术在6个月时并未增加角化组织高度，且使龈黏膜联合处向冠方移位更多。
