Joly Julio C, Carvalho Alexandre M, da Silva Robert C, Ciotti Danilo L, Cury Patricia R
Department of Periodontics, São Leopoldo Mandic Dental Research Center, Campinas, SP, Brazil.
J Periodontol. 2007 Jun;78(6):1017-22. doi: 10.1902/jop.2007.060428.
Different surgical techniques have been used to treat gingival recessions. This preliminary study compared clinical findings for the treatment of isolated gingival defects using a coronally positioned flap associated with a subepithelial connective tissue graft or an acellular dermal matrix graft.
Ten subjects with bilateral and comparable Miller Class I or II defects were selected. The defects were > or =3.0 mm deep and were assigned randomly to the test group, which was treated with a coronally positioned flap associated with an acellular dermal matrix, or to the control group, which was treated with a coronally positioned flap associated with a subepithelial connective tissue graft. Probing depth (PD), clinical attachment level (CAL), gingival recession depth (GRD), and width (KT) and thickness (GT) of the keratinized tissue were assessed at baseline and 6 months after the surgery.
Mean root coverage was 50% in the test group (representing a gingival margin shift of 2.1 +/- 0.99 mm) and 79.5% in the control group (representing a gingival margin shift of 3.5 +/- 1.20 mm). These results were statistically different on intra- and intergroup comparisons (P <0.05). Between-group comparisons revealed statistically significantly greater gains in CAL, GRD, and GT in the control group (P < or =0.05); no differences were found for PD or KT (P > or =0.05).
The coronally positioned flap associated with a subepithelial connective tissue graft or an acellular dermal matrix graft was effective in root coverage. However, the coronally positioned flap associated with a connective tissue graft provided a more favorable clinical outcome. More expanded studies are needed to confirm the present findings.
不同的手术技术已被用于治疗牙龈退缩。这项初步研究比较了使用冠向复位瓣联合上皮下结缔组织移植或脱细胞真皮基质移植治疗孤立性牙龈缺损的临床结果。
选择10名患有双侧且可比的米勒I类或II类缺损的受试者。缺损深度≥3.0mm,并随机分配至试验组,该组采用冠向复位瓣联合脱细胞真皮基质进行治疗,或分配至对照组,该组采用冠向复位瓣联合上皮下结缔组织移植进行治疗。在基线和手术后6个月评估探诊深度(PD)、临床附着水平(CAL)、牙龈退缩深度(GRD)以及角化组织的宽度(KT)和厚度(GT)。
试验组的平均牙根覆盖率为50%(代表牙龈边缘移位2.1±0.99mm),对照组为79.5%(代表牙龈边缘移位3.5±1.20mm)。这些结果在组内和组间比较中具有统计学差异(P<0.05)。组间比较显示,对照组在CAL、GRD和GT方面的改善具有统计学显著意义(P≤0.05);PD或KT未发现差异(P≥0.05)。
冠向复位瓣联合上皮下结缔组织移植或脱细胞真皮基质移植在牙根覆盖方面是有效的。然而,冠向复位瓣联合结缔组织移植提供了更有利的临床结果。需要更多广泛的研究来证实目前的发现。