Aimetti Mario, Romano Federica, Peccolo Daniela C, Debernardi Cesare
Department of Medical Sciences and Human Oncology, Section of Periodontology, University of Torino, Torino, Italy.
J Periodontol. 2005 Feb;76(2):256-61. doi: 10.1902/jop.2005.76.2.256.
There is a large amount of data on surgical root coverage procedures for the treatment of gingival recessions but no controlled clinical trials on the behavior of marginal gingiva following non-surgical therapy. The aim of our study was to compare in terms of root coverage two different modalities of root surface treatment, root planing and polishing versus polishing alone, over a 12-month period.
The study was conducted in a split-mouth design. Twenty-four non-smoking patients (14 females and 10 males, mean age 25.17 4.03 years) with high levels of oral hygiene (full-mouth plaque score <20%) and with two bilateral Class I buccal recessions up to 2 mm deep were selected for the study. In each patient one recession was randomly assigned to the test group and the contra-lateral one to the control group. In the test group the exposed root surface was gently debrided and polished with mini curets and mini rubber cups, while the control group was polished only. The root surface instrumentation was repeated twice a month during the first 2 months and at 2-month intervals over the next 10 months. Clinical measurements were taken at baseline and 12 months post-therapy.
At baseline the mean recession depth in the test group was 1.64 +/- 0.37 mm and in the control sites 1.43 +/- 0.42 mm, which decreased at 12 months to 0.78 +/- 0.60 mm and to 1.34 +/- 0.45 mm, respectively. The difference between the two groups was significant (P <0.0001). No significant differences were observed in keratinized tissue width and probing depth improvements.
The removal of microbial toxins from the exposed root surfaces by polishing prevents further progression of gingival recession; the reduction of root convexity by scaling and root planing promotes the coronal shift of the gingival margin.
有大量关于手术性牙根覆盖术治疗牙龈退缩的数据,但对于非手术治疗后边缘龈行为的对照临床试验却未见报道。我们研究的目的是在12个月的时间里,比较两种不同的牙根表面处理方式——根面平整和抛光与单纯抛光——在牙根覆盖方面的效果。
本研究采用分口设计。选取24名不吸烟患者(14名女性和10名男性,平均年龄25.17±4.03岁),口腔卫生状况良好(全口菌斑评分<20%),且有两个双侧I类颊侧牙龈退缩,深度达2mm。在每位患者中,随机将一个牙龈退缩部位分配到试验组,对侧部位分配到对照组。试验组用微型刮治器和微型橡胶杯轻柔地清除暴露的牙根表面并进行抛光,而对照组仅进行抛光。在最初的2个月里,每月重复进行两次牙根表面器械操作,在接下来的10个月里每隔2个月进行一次。在基线和治疗后12个月进行临床测量。
基线时,试验组平均退缩深度为1.64±0.37mm,对照部位为1.43±0.42mm,12个月时分别降至0.78±0.60mm和1.34±0.45mm。两组之间的差异具有统计学意义(P<0.0001)。在角化组织宽度和探诊深度改善方面未观察到显著差异。
通过抛光去除暴露牙根表面的微生物毒素可防止牙龈退缩进一步发展;通过刮治和根面平整减少牙根凸度可促进牙龈边缘向冠方移动。