Tal Haim, Moses Ofer, Zohar Ron, Meir Haya, Nemcovsky Carlos
Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
J Periodontol. 2002 Dec;73(12):1405-11. doi: 10.1902/jop.2002.73.12.1405.
Acellular dermal matrix allograft (ADMA) has successfully been applied as a substitute for free connective tissue grafts (CTG) in various periodontal procedures, including root coverage. The purpose of this study was to clinically compare the efficiency of ADMA and CTG in the treatment of gingival recessions > or = 4 mm.
Seven patients with bilateral recession lesions participated. Fourteen teeth presenting gingival recessions > or = 4 mm were randomly treated with ADMA or CTG covered by coronally advanced flaps. Recession, probing depth, and width of keratinized tissue were measured preoperatively and 12 months postoperatively. Changes in these clinical parameters were calculated within and compared between groups and analyzed statistically.
Baseline recession, probing depth, and keratinized tissue width were similar for both groups. At 12 months, root coverage gain was 4.57 mm (89.1%) versus 4.29 mm (88.7%) (P = NS), and keratinized tissue gain was 0.86 mm (36%) versus 2.14 mm (107%) (P < 0.05) for ADMA and CTG, respectively. Probing depth remained unchanged (0.22 mm/0 mm), with no difference between the groups.
Recession defects may be covered using ADMA or CTG, with no practical difference. However, CTG results in significantly greater gain of keratinized gingiva.
脱细胞真皮基质同种异体移植物（ADMA）已成功应用于包括根面覆盖在内的各种牙周手术中，作为游离结缔组织移植（CTG）的替代物。本研究的目的是临床比较ADMA和CTG治疗≥4mm牙龈退缩的疗效。
7例双侧牙龈退缩病变患者参与研究。14颗牙龈退缩≥4mm的牙齿被随机采用ADMA或CTG覆盖，并联合冠向推进瓣进行治疗。术前及术后12个月测量退缩、探诊深度和角化组织宽度。计算这些临床参数在组内的变化并进行组间比较，然后进行统计学分析。
两组的基线退缩、探诊深度和角化组织宽度相似。12个月时，ADMA组和CTG组的根面覆盖增加分别为4.57mm（89.1%）和4.29mm（88.7%）（P=无显著性差异），角化组织增加分别为0.86mm（36%）和2.14mm（107%）（P<0.05）。探诊深度保持不变（0.22mm/0mm），两组间无差异。
ADMA或CTG均可覆盖退缩缺损，实际效果无差异。然而，CTG能显著增加角化牙龈。
