Tözüm Tolga F, Dini Farid M
Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, Turkey.
Quintessence Int. 2003 Jan;34(1):7-13.
There has been great interest in the treatment of gingival recession defects, especially with subepithelial connective tissue grafting. Recent advances have focused on subepithelial connective tissue grafting by the tunnel technique. In this clinical study, a modified periodontal plastic surgery technique for coverage of adjacent gingival recessions was performed. This surgical modification was based on the tunnel technique without vertical incisions, where the partial dissection was converted to a full-thickness dissection at the mucogingival area to supply more blood vessels.
Patients, each contributing at least two adjacent buccal gingival recessions, were treated. Subepithelial connective tissue grafting was used to cover the defects. Gingival recession, probing depth, and attachment level were measured at baseline and 8 months posttreatment.
There were statistically significant improvements in attachment level and gingival recession after 8 months; the mean gain in attachment was 3.67 mm and the mean root coverage was 3.28 mm, which translated to mean root coverage of 95%.
These findings suggest that subepithelial connective tissue grafting with a modified tunnel approach, in which the partial-thickness flap is converted to a full-thickness flap in a coronoapical direction, results in adequate early healing and highly predictable root coverage in adjacent gingival recessions.
牙龈退缩缺损的治疗一直备受关注，尤其是上皮下结缔组织移植术。近期进展集中在隧道技术进行上皮下结缔组织移植。在这项临床研究中，实施了一种改良的牙周整形手术技术来覆盖相邻的牙龈退缩。这种手术改良基于无垂直切口的隧道技术，在膜龈区域将部分剥离转换为全层剥离以提供更多血管。
治疗至少有两个相邻颊侧牙龈退缩的患者。采用上皮下结缔组织移植覆盖缺损。在基线和治疗后8个月测量牙龈退缩、探诊深度和附着水平。
8个月后附着水平和牙龈退缩有统计学显著改善；附着平均增加3.67毫米，平均牙根覆盖为3.28毫米，相当于平均牙根覆盖率为95%。
这些发现表明，采用改良隧道法进行上皮下结缔组织移植，即将部分厚度瓣沿冠根方向转换为全厚度瓣，可实现早期充分愈合，并能高度可预测地覆盖相邻牙龈退缩的牙根。
