Griffin Terrence J, Cheung Wai S
Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA.
J Periodontol. 2009 Jul;80(7):1192-9. doi: 10.1902/jop.2009.080609.
A platelet concentrate graft (PCG) was applied underneath the barrier membrane in guided tissue regeneration (GTR)-based root coverage procedures. The purpose of this case study was to assess the effectiveness of the technique and the long-term outcomes.
Thirty-seven Miller Class I or II recession defects in six patients were treated using the PCG and a collagen membrane covered by an advanced mucogingival flap. Clinical parameters, such as vertical gingival recession depth (VRD), clinical attachment level (CAL), probing depth (PD), and width of keratinized tissue (WKT), were recorded presurgery (at baseline [BL]) and at 6 and 36 months of follow-up. The Wilcoxon signed-rank test and the Mann-Whitney test were used to assess statistical significance (alpha = 0.05).
Between BL and 6 months, there was a statistically significant reduction in VRD (from 2.81 +/- 0.88 mm to 0.30 +/- 0.48 mm) and PD (from 2.59 +/- 0.50 mm to 1.14 +/- 0.35 mm), as well as an improvement in CAL (from 5.41 +/- 0.86 mm to 1.43 +/- 0.66 mm). These results remained stable over the following 30 months. There was no statistically significant change in WKT during the initial 6 months; however, the increase in WKT was statistically significant at the 36-month follow-up. When comparing the healing between the maxillary and mandibular teeth at 6 months, the VRD reduction was statistically significantly greater in the maxillary teeth, but the difference was not statistically significant 30 months later. The average root coverage at 6 and 36 months was 89.86% +/- 15.85% and 85.86% +/- 18.16%, respectively, with complete root coverage in 24 (64.86%) and 21 (56.76%) of the 37 teeth.
The GTR-based technique using PCG was effective in reducing gingival recession. The outcomes remained stable for 3 years.
在基于引导组织再生（GTR）的牙根覆盖手术中，将浓缩血小板移植物（PCG）应用于屏障膜下方。本病例研究的目的是评估该技术的有效性和长期效果。
对6例患者的37个Miller I类或II类牙龈退缩缺损采用PCG和覆盖有改良黏膜牙龈瓣的胶原膜进行治疗。在术前（基线[BL]）以及随访6个月和36个月时记录临床参数，如垂直牙龈退缩深度（VRD）、临床附着水平（CAL）、探诊深度（PD）和角化组织宽度（WKT）。采用Wilcoxon符号秩检验和Mann-Whitney检验评估统计学意义（α = 0.05）。
在基线和6个月之间，VRD（从2.81±0.88 mm降至0.30±0.48 mm）和PD（从2.59±0.50 mm降至1.14±0.35 mm）有统计学意义的降低，CAL也有改善（从5.41±0.86 mm增至1.43±0.66 mm）。这些结果在接下来的30个月中保持稳定。在最初6个月内WKT无统计学意义的变化；然而，在36个月随访时WKT的增加有统计学意义。在6个月时比较上颌牙和下颌牙的愈合情况，上颌牙的VRD降低在统计学上显著更大，但30个月后差异无统计学意义。6个月和36个月时的平均牙根覆盖率分别为89.86%±15.85%和85.86%±18.16%，37颗牙中有24颗（64.86%）和21颗（56.76%）实现了完全牙根覆盖。
使用PCG的基于GTR的技术在减少牙龈退缩方面有效。其效果在3年内保持稳定。
