Lee Eun-Ju, Meraw Stephen J, Oh Tae-Ju, Giannobile William V, Wang Hom-Lay
Department of Periodontics/Prevention/Geriatrics, School of Dentistry, University of Michigan, Ann Arbor 48109-1078, USA.
J Periodontol. 2002 Jul;73(7):779-88. doi: 10.1902/jop.2002.73.7.779.
Guided tissue regeneration (GTR)-based root coverage has been utilized to correct gingival recession defects with promising results. However, limited histologic information is available. Therefore, the aims of this study were to clinically and histologically evaluate the efficacy of GTR-based root coverage using collagen membrane (GTRC) and to compare the healing response to that of coronally advanced flaps (CAF).
Standardized gingival recession defects were surgically created on the labial surfaces of the maxillary cuspids of 8 mongrel dogs. Plaque was allowed to accumulate for 8 weeks to develop a plaque-infected recession defect. Full-mouth scaling and root planing was then performed coincident with 4 weeks of oral hygiene. Defects were randomly assigned to receive either GTRC or CAF surgery. Four dogs each were sacrificed at 4 and 16 weeks post-treatment. Clinical measurements included: percent root coverage, the amount of keratinized gingiva (KG), and probing depth (PD). Sulcular depth, junctional epithelium and connective tissue attachment, new cementum formation, and new bone formation were evaluated histomorphometrically.
Clinically, both treatments (CAF and GTRC) achieved statistically significant (P <0.05) root coverage compared to baseline. KG was significantly increased in CAF-treated sites at 16 weeks, while no significant differences were found for other clinical parameters between treatments. Histometrically, GTRC showed a statistically significant increase of new attachment and newly formed connective tissue when compared to CAF at 16 weeks.
Within the limits of this preclinical study, both GTRC and CAF can be successfully used for the treatment of gingival recession defects.
基于引导组织再生(GTR)的牙根覆盖术已被用于纠正牙龈退缩缺陷,效果良好。然而,可用的组织学信息有限。因此,本研究的目的是从临床和组织学角度评估使用胶原膜的基于GTR的牙根覆盖术(GTRC)的疗效,并将其愈合反应与冠向推进瓣(CAF)的愈合反应进行比较。
在8只杂种犬上颌尖牙的唇面手术制造标准化的牙龈退缩缺陷。让菌斑积聚8周以形成菌斑感染的退缩缺陷。然后在进行4周口腔卫生护理的同时进行全口洁治和根面平整。将缺陷随机分配接受GTRC或CAF手术。在治疗后4周和16周分别处死4只犬。临床测量包括:牙根覆盖百分比、角化龈(KG)量和探诊深度(PD)。通过组织形态计量学评估龈沟深度、结合上皮和结缔组织附着、新牙骨质形成和新骨形成。
临床上,与基线相比,两种治疗方法(CAF和GTRC)均实现了具有统计学意义(P<0.05)的牙根覆盖。在16周时,CAF治疗部位的KG显著增加,而两种治疗方法之间的其他临床参数未发现显著差异。组织计量学上,与16周时的CAF相比,GTRC显示新附着和新形成的结缔组织有统计学意义的增加。
在这项临床前研究的范围内,GTRC和CAF均可成功用于治疗牙龈退缩缺陷。