Spahr Axel, Haegewald Stefan, Tsoulfidou Fotini, Rompola Eirini, Heijl Lars, Bernimoulin Jean-Pierre, Ring Christina, Sander Silvia, Haller Bernd
Conservative Dentistry and Periodontology, University of Ulm, Ulm, Germany.
J Periodontol. 2005 Nov;76(11):1871-80. doi: 10.1902/jop.2005.76.11.1871.
The aim of this study was to evaluate a comparison of the coronally advanced flap procedure with or without the use of enamel matrix proteins in the treatment of recession defects.
This 2-year study was conducted as a blinded, split-mouth, placebo-controlled, and randomized design. Thirty patients from two dental schools with two paired buccal recession defects were chosen. Surgical recession coverage was performed as the coronally advanced flap technique. One site was additionally treated with derivative (EMD) and the other site with a placebo (propylene glycol alginate [PGA]). A blinded examiner assessed pre- and post-surgical measurements. Measurements comprised the height and width of the gingival recession, height of keratinized tissue, probing attachment level, probing depth, and alveolar bone level.
Twenty-four months after therapy, both treatment modalities showed significant root coverage and probing attachment gain. The mean gingival recession decreased from 3.6 to 0.8 mm for the EMD-treated sites and from 3.8 to 1.4 mm for the control sites. However, this difference was not statistically significant (P = 0.122). Similarly, all other clinical parameters did not differ significantly in the between-group comparison except for the recession width (P = 0.027) and probing depth (P = 0.046) exhibiting higher reductions in the EMD group. Complete root coverage could be maintained over 2 years in 53% of the EMD versus merely 23% in the control group. A total of 47% of the treated recessions in the control group deteriorated again in the second year after therapy compared to 22% in the EMD group.
Enamel matrix derivative seems to provide better long-term results.
本研究旨在评估在治疗牙龈退缩缺损时，使用或不使用釉基质蛋白的冠向推进瓣手术的效果比较。
本为期两年的研究采用双盲、分口、安慰剂对照和随机设计。从两所牙科学院选取30例患者，其双侧颊侧牙龈均有配对的退缩缺损。手术采用冠向推进瓣技术覆盖退缩部位。其中一侧额外使用釉基质衍生物（EMD）治疗，另一侧使用安慰剂（海藻酸丙二醇酯[PGA]）治疗。由一位双盲检查者评估手术前后的各项测量指标。测量指标包括牙龈退缩的高度和宽度、角化组织高度、探诊附着水平、探诊深度和牙槽骨水平。
治疗24个月后，两种治疗方式均显示出显著的牙根覆盖和探诊附着增加。接受EMD治疗的部位，平均牙龈退缩从3.6毫米降至0.8毫米；对照组部位则从3.8毫米降至1.4毫米。然而，这种差异无统计学意义（P = 0.122）。同样，除了退缩宽度（P = 0.027）和探诊深度（P = 0.046）在EMD组降低更明显外，其他所有临床参数在组间比较中均无显著差异。53%接受EMD治疗的部位在两年内可维持完全牙根覆盖，而对照组仅为23%。与EMD组的22%相比，对照组47%接受治疗的退缩部位在治疗后第二年再次恶化。
釉基质衍生物似乎能提供更好的长期效果。
