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两种使用脱细胞真皮基质移植物治疗牙龈退缩的手术方法比较:一项随机对照临床研究。

Comparison of two surgical procedures for use of the acellular dermal matrix graft in the treatment of gingival recessions: a randomized controlled clinical study.

作者信息

Felipe Maria Emília M C, Andrade Patrícia F, Grisi Marcio F M, Souza Sérgio L S, Taba Mário, Palioto Daniela B, Novaes Arthur B

机构信息

Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

出版信息

J Periodontol. 2007 Jul;78(7):1209-17. doi: 10.1902/jop.2007.060356.

Abstract

BACKGROUND

The aim of this randomized, controlled, clinical investigation was to compare two surgical techniques for root coverage with the acellular dermal matrix graft to evaluate which technique provided better root coverage, a better esthetic result, and less postoperative discomfort.

METHODS

Fifteen patients with bilateral Miller Class I or II gingival recessions were selected. Fifteen pairs of recessions were treated and assigned randomly to the test group, and the contralateral recessions were assigned to the control group. The control group was treated with a broader flap and vertical releasing incisions; the test group was treated with the proposed surgical technique, without vertical releasing incisions. The clinical parameters evaluated were probing depth, relative clinical attachment level, gingival recession (GR), width of keratinized tissue, thickness of keratinized tissue, esthetic result, and pain evaluation. The measurements were taken before the surgeries and after 6 months.

RESULTS

At baseline, all parameters were similar for both groups. At 6 months, a statistically significant greater reduction in GR favored the control group. The percentage of root coverage was 68.98% and 84.81% for the test and control groups, respectively. The esthetic result was equivalent between the groups, and all patients tolerated both procedures well.

CONCLUSIONS

Both techniques provided significant root coverage, good esthetic results, and similar levels of postoperative discomfort. However, the control technique had statistically significantly better results for root coverage of localized gingival recessions.

摘要

背景

本随机对照临床研究旨在比较两种使用脱细胞真皮基质移植物进行根面覆盖的手术技术,以评估哪种技术能提供更好的根面覆盖效果、美学效果以及更少的术后不适。

方法

选取15例双侧米勒I类或II类牙龈退缩患者。对15对退缩部位进行治疗,随机将其分配至试验组,对侧退缩部位分配至对照组。对照组采用较宽的瓣和垂直松弛切口进行治疗;试验组采用所提议的手术技术进行治疗,不做垂直松弛切口。评估的临床参数包括探诊深度、相对临床附着水平、牙龈退缩(GR)、角化组织宽度、角化组织厚度、美学效果和疼痛评估。在手术前和术后6个月进行测量。

结果

基线时,两组所有参数相似。6个月时,GR的统计学显著更大程度降低有利于对照组。试验组和对照组的根面覆盖百分比分别为68.98%和84.81%。两组之间美学效果相当,所有患者对两种手术的耐受性均良好。

结论

两种技术均能提供显著的根面覆盖、良好的美学效果以及相似程度的术后不适。然而,对于局限性牙龈退缩的根面覆盖,对照技术在统计学上具有显著更好的效果。

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