Souza Sérgio L S, Macedo Guilherme O, Tunes Roberta S, Silveira e Souza Adriana M M, Novaes Arthur B, Grisi Marcio F M, Taba Mário, Palioto Daniela B, Correa Vani M A
Department of Bucco-Maxillofacial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café s/n, Monte Alegre, Ribeirão Preto, SP, Brazil.
J Periodontol. 2008 Jun;79(6):1014-21. doi: 10.1902/jop.2008.070479.
The aim of this study was to evaluate root coverage of gingival recessions and to compare graft vascularization in smokers and non-smokers.
Thirty subjects, 15 smokers and 15 non-smokers, were selected. Each subject had one Miller Class I or II recession in a non-molar tooth. Clinical measurements of probing depth (PD), relative clinical attachment level (CAL), gingival recession (GR), and width of keratinized tissue (KT) were determined at baseline and 3 and 6 months after surgery. The recessions were treated surgically with a coronally positioned flap associated with a subepithelial connective tissue graft. A small portion of this graft was prepared for immunohistochemistry. Blood vessels were identified and counted by expression of factor VIII-related antigen-stained endothelial cells.
Intragroup analysis showed that after 6 months there a was gain in CAL, a decrease in GR, and an increase in KT for both groups (P <0.05), whereas changes in PD were not statistically significant. Smokers had less root coverage than non-smokers (58.02% +/- 19.75% versus 83.35% +/- 18.53%; P <0.05). Furthermore, the smokers had more GR (1.48 +/- 0.79 mm versus 0.52 +/- 0.60 mm) than the non-smokers (P <0.05). Histomorphometry of the donor tissue revealed a blood vessel density of 49.01 +/- 11.91 vessels/200x field for non-smokers and 36.53 +/- 10.23 vessels/200x field for smokers (P <0.05).
Root coverage with subepithelial connective tissue graft was negatively affected by smoking, which limited and jeopardized treatment results.
本研究的目的是评估牙龈退缩的牙根覆盖情况，并比较吸烟者和非吸烟者移植物的血管化情况。
选取30名受试者，其中15名吸烟者和15名非吸烟者。每名受试者在一颗非磨牙上有一处米勒I类或II类牙龈退缩。在基线以及术后3个月和6个月时，测定探诊深度（PD）、相对临床附着水平（CAL）、牙龈退缩（GR）和角化组织宽度（KT）的临床指标。采用冠向复位瓣联合上皮下结缔组织移植术对牙龈退缩进行手术治疗。取一小部分该移植物用于免疫组织化学分析。通过VIII因子相关抗原染色的内皮细胞表达来识别和计数血管。
组内分析显示，6个月后两组的CAL均增加，GR均降低，KT均增加（P<0.05），而PD的变化无统计学意义。吸烟者的牙根覆盖情况低于非吸烟者（58.02%±19.75%对83.35%±18.53%；P<0.05）。此外，吸烟者的GR比非吸烟者更多（1.48±0.79mm对0.52±0.60mm；P<0.05）。供体组织的组织形态计量学显示，非吸烟者的血管密度为49.01±11.91条/200倍视野，吸烟者为36.53±10.23条/200倍视野（P<0.05）。
吸烟对上皮下结缔组织移植的牙根覆盖有负面影响，限制并危及治疗效果。
