Wang Hom-Lay, Kimble Kenneth, Eber Robert
Department of Periodontics/Prevention/Geriatrics, School of Dentistry, University of Michigan, Ann Arbor 48109-1078, USA.
Int J Periodontics Restorative Dent. 2002 Apr;22(2):119-27.
The use of guided tissue regeneration (GTR) procedures for the treatment of gingival recession has shown encouraging results and is gaining clinical acceptance. However, attaining space maintenance beneath the membrane remains a problem for clinicians. Hence, the purpose of this pilot case study was to evaluate the effect of adjunctive demineralized freeze-dried bone allograft (DFDBA) placement during collagen membrane GTR-based root coverage procedures. Five patients with Miller Class I or II defects were treated with a combination of DFDBA and collagen membrane. Clinical parameters monitored include recession depth, probing attachment level, probing depth, width of keratinized gingiva, and recession width. Measurements were taken at baseline and 6 months. A statistically significant reduction in recession depth (3.1 +/- 0.7 mm) was observed at 6 months, representing 93.4% total attainable root coverage. A significant reduction of recession width (3.5 +/- 1.2 mm) after 6 months was also noted. Clinically, a statistically significant mean gain of 3.3 +/- 0.6 mm in clinical attachment and 0.8 +/- 0.9 mm in keratinized gingiva were obtained at 6 months. No statistically significant difference was found in probing depth between baseline and 6 months postoperative. Plaque and gingival indices remained low and showed no statistically significant change throughout the study period. Results from this pilot case study indicate that use of DFDBA during collagen membrane GTR-based root coverage could be beneficial.
引导组织再生（GTR）程序用于治疗牙龈退缩已显示出令人鼓舞的结果，并逐渐获得临床认可。然而，在膜下实现空间维持对临床医生来说仍然是一个问题。因此，本初步病例研究的目的是评估在基于胶原膜GTR的牙根覆盖程序中辅助放置脱矿冻干骨同种异体移植物（DFDBA）的效果。五名患有米勒I类或II类缺损的患者接受了DFDBA和胶原膜联合治疗。监测的临床参数包括退缩深度、探诊附着水平、探诊深度、角化龈宽度和退缩宽度。在基线和6个月时进行测量。6个月时观察到退缩深度有统计学意义的降低（3.1±0.7mm），代表可实现的牙根总覆盖率为93.4%。6个月后还注意到退缩宽度有显著降低（3.5±1.2mm）。临床上，6个月时临床附着平均有统计学意义的增加3.3±0.6mm，角化龈增加0.8±0.9mm。基线和术后6个月之间探诊深度未发现统计学显著差异。在整个研究期间，菌斑和牙龈指数保持较低，且未显示出统计学显著变化。本初步病例研究的结果表明，在基于胶原膜GTR的牙根覆盖过程中使用DFDBA可能是有益的。
