Lins Lauro Henrique Souza, de Lima Antonio Fernando Martorelli, Sallum Antonio Wilson
Health Science Center, Dentistry Course, Lages, Santa Catarina, Brazil.
J Periodontol. 2003 Feb;74(2):168-74. doi: 10.1902/jop.2003.74.2.168.
Various surgical procedures have been proposed as effective treatment methods for recession defects. The purpose of this study was to evaluate the clinical outcome of root coverage comparing the coronally positioned flap (CPF) with and without guided tissue regeneration (GTR) using a titanium-reinforced expanded polytetrafluoroethylene barrier in paired gingival recession defects.
Procedures were performed in 10 patients having bilateral buccal recession defects > or = 2.0 mm on maxillary canines and first premolars. Mucoperiosteal flaps were raised and root surfaces were scaled, planed, and conditioned. Randomly assigned sites received either GTR + CPF or CPF treatment. Clinical parameters measured at baseline and at 6 months after the procedure included gingival recession depth (GRD), clinical attachment level (CAL), probing depth (PD), keratinized gingival width (KGW), and alveolar crest level (ACL).
GRD decreased from 3.4 +/- 0.6 mm to 1.9 +/- 1.2 mm with GTR (45% root coverage) and from 3.3 +/- 0.4 mm to 1.3 +/- 0.7 mm with CPF (60% root coverage). The difference in GRD decrease between procedures was significant. CAL, KGW, and PD differences between procedures were not significant. ACL mean gain was significant (1.0 +/- 0.6 mm in the GTR group and 0.2 +/- 0.3 mm in the CPF group; P < 0.05).
Both GTR and CPF procedures result in root coverage. The amount of root coverage obtained with CPF was greater than that observed with GTR, although GTR resulted in significantly greater ACL gain.
已提出多种外科手术方法作为治疗牙龈退缩缺损的有效方法。本研究的目的是在配对的牙龈退缩缺损中,比较使用钛增强型膨体聚四氟乙烯屏障的冠向复位瓣(CPF)联合引导组织再生(GTR)与不联合GTR时的牙根覆盖临床效果。
对10例上颌尖牙和第一前磨牙双侧颊侧牙龈退缩缺损≥2.0 mm的患者进行手术。掀起黏骨膜瓣,对牙根表面进行刮治、平整和预处理。随机分配的部位接受GTR+CPF或CPF治疗。在基线和术后6个月测量的临床参数包括牙龈退缩深度(GRD)、临床附着水平(CAL)、探诊深度(PD)、角化龈宽度(KGW)和牙槽嵴水平(ACL)。
GTR组GRD从3.4±0.6 mm降至1.9±1.2 mm(牙根覆盖45%),CPF组从3.3±0.4 mm降至1.3±0.7 mm(牙根覆盖60%)。两组间GRD降低的差异有统计学意义。两组间CAL、KGW和PD的差异无统计学意义。ACL平均增加有统计学意义(GTR组为1.0±0.6 mm,CPF组为0.2±0.3 mm;P<0.05)。
GTR和CPF手术均能实现牙根覆盖。CPF获得的牙根覆盖量大于GTR,尽管GTR导致ACL增加更为显著。