Harris Randall J
J Periodontol. 2004 May;75(5):734-43. doi: 10.1902/jop.2004.75.5.734.
Obtaining predictable and esthetic root coverage has become important. Unfortunately, there is only a limited amount of information available on the long-term results of root coverage procedures. The goal of this study was to evaluate the short-term and long-term root coverage results obtained with an acellular dermal matrix and a subepithelial graft.
An a priori power analysis was done to determine that 25 was an adequate sample size for each group in this study. Twenty-five patients treated with either an acellular dermal matrix or a subepithelial graft for root coverage were included in this study. The short-term (mean 12.3 to 13.2 weeks) and long-term (mean 48.1 to 49.2 months) results were compared. Additionally, various factors were evaluated to determine whether they could affect the results. This study was a retrospective study of patients in a fee-for-service private periodontal practice. The patients were not randomly assigned to treatment groups.
The mean root coverages for the short-term acellular dermal matrix (93.4%), short-term subepithelial graft (96.6%), and long-term subepithelial graft (97.0%) were statistically similar. All three were statistically greater than the long-term acellular dermal matrix mean root coverage (65.8%). Similar results were noted in the change in recession. There were smaller probing reductions and less of an increase in keratinized tissue with the acellular dermal matrix than the subepithelial graft. None of the factors evaluated resulted in the acellular dermal graft having a statistically significant better result than the subepithelial graft. However, in long-term cases where multiple defects were treated with an acellular dermal matrix, the mean root coverage (70.8%) was greater than the mean root coverage in long-term cases where a single defect was treated with an acellular dermal matrix (50.0%).
The mean results with the subepithelial graft held up with time better than the mean results with an acellular dermal matrix. However, the results were not universal. In 32.0% of the cases treated with an acellular dermal matrix, the results improved or remained stable with time.
获得可预测且美观的牙根覆盖已变得至关重要。遗憾的是，关于牙根覆盖手术长期效果的可用信息有限。本研究的目的是评估使用脱细胞真皮基质和上皮下移植获得的短期和长期牙根覆盖效果。
进行了一项先验功效分析，以确定本研究中每组25例为足够的样本量。本研究纳入了25例接受脱细胞真皮基质或上皮下移植进行牙根覆盖治疗的患者。比较了短期（平均12.3至13.2周）和长期（平均48.1至49.2个月）的结果。此外，评估了各种因素以确定它们是否会影响结果。本研究是对一家按服务收费的私人牙周诊所患者的回顾性研究。患者未被随机分配到治疗组。
短期脱细胞真皮基质（93.4%）、短期上皮下移植（96.6%）和长期上皮下移植（97.0%）的平均牙根覆盖在统计学上相似。这三者在统计学上均高于长期脱细胞真皮基质的平均牙根覆盖（65.8%）。在牙龈退缩变化方面也观察到了类似结果。与上皮下移植相比，脱细胞真皮基质的探诊深度减少较小，角化组织增加较少。所评估的因素均未使脱细胞真皮移植的结果在统计学上显著优于上皮下移植。然而，在长期使用脱细胞真皮基质治疗多个缺损的病例中，平均牙根覆盖（70.8%）大于长期使用脱细胞真皮基质治疗单个缺损病例的平均牙根覆盖（50.0%）。
上皮下移植的平均效果随时间推移比脱细胞真皮基质的平均效果保持得更好。然而，结果并非普遍如此。在32.0%接受脱细胞真皮基质治疗的病例中，结果随时间改善或保持稳定。
