Rahmani M E, Lades Mohammad A Rigi
Graduate Program, School of Dentistry and Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
J Contemp Dent Pract. 2006 May 1;7(2):63-70.
"Gingival recession is a condition reported to occur due to abnormal periodontal anatomy, poor hygiene, excessive occlusal forces, toothbrush abrasion, and even iatrogenic or factitious causes. Though various surgical techniques are available to treat this problem, the most common is the palatal soft tissue autograft. Recently, an acellular dermal matrix allograft (ADMA) has been available as a substitute for the palatal tissue harvest. The aim of this study is to compare the ADMA with the conventional subepithelial connective tissue graft (SCTG) in the treatment of gingival recession."
Fourteen patients with 20 gingival recessions of Miller's grade I and II were selected and randomized in two groups of control (SCTG ) and test (ADMA). In each group ten recession defects were treated. The following parameters were measured at baseline and then at six months post surgery: recession height (RH), recession width (RW), probing depth (PD), attached gingiva (AG), keratinized gingiva (KG), and clinical attachment level (CAL). All parameters were analyzed using the two-sample t-test. Data analysis was performed using SPSS (version 11) software.
The following mean changes (mm) occurred in SCTG and ADMA, respectively: 2.60+/-0.97 and 2.90+/-0.81 decrease in RH; 1.70+/-1.01 and 1.65+/-0.67 decrease in RW; 2.50+/-0.97 and 2.95+/-0.69 increase in KG; 2.25+/-0.92 and 2.65+/-0.85 increase in AG; 2.60+/-1.08 and 2.75+/-0.92 decrease in CAL; and finally 0.05+/-0.50 and 0.10+/-0.46 decrease in PD for the SCTG and ADMA groups, respectively. The percentage of root coverage for the two groups was 70.12%+/-22.81% and 72.08%+/-14.12%, respectively. The changes from baseline to the six-month visit were significant for both groups in terms of all parameters but PD. However, the differences in mean changes were not significant between the two groups in any of the parameters.
These findings imply the ADMA and SCTG techniques could produce the same results when used for the successful treatment of gingival recessions. In addition the ADMA could be used as an adequate alternative treatment modality for conventional techniques.
“牙龈退缩是一种据报道因牙周解剖结构异常、口腔卫生不良、咬合力过大、牙刷磨损甚至医源性或人为因素而发生的病症。尽管有多种手术技术可用于治疗此问题，但最常用的是腭部软组织自体移植。最近，脱细胞真皮基质同种异体移植物（ADMA）已可作为腭部组织采集的替代物。本研究的目的是比较ADMA与传统的上皮下结缔组织移植（SCTG）在治疗牙龈退缩方面的效果。”
选择14例患有20处米勒I级和II级牙龈退缩的患者，并随机分为对照组（SCTG）和试验组（ADMA）两组。每组治疗10处退缩缺损。在基线时以及术后6个月测量以下参数：退缩高度（RH）、退缩宽度（RW）、探诊深度（PD）、附着龈（AG）、角化龈（KG）和临床附着水平（CAL）。所有参数均使用两样本t检验进行分析。使用SPSS（11版）软件进行数据分析。
SCTG组和ADMA组分别出现以下平均变化（mm）：RH分别降低2.60±0.97和2.90±0.81；RW分别降低1.70±1.01和1.65±0.67；KG分别增加2.50±0.97和2.95±0.69；AG分别增加2.25±0.92和2.65±0.85；CAL分别降低2.60±1.08和2.75±0.92；最后，SCTG组和ADMA组的PD分别降低0.05±0.50和0.10±0.46。两组的牙根覆盖百分比分别为70.12%±22.81%和72.08%±14.12%。两组从基线到6个月随访时在所有参数（除PD外）方面的变化均具有显著性。然而，两组在任何参数的平均变化差异均无显著性。
这些发现表明，ADMA和SCTG技术在成功治疗牙龈退缩时可产生相同的结果。此外，ADMA可作为传统技术的一种合适替代治疗方式。
