J Periodontol. 2010 Aug;81(8):1108-17. doi: 10.1902/jop.2010.090698.
For root coverage therapy, the connective tissue graft (CTG) plus coronally advanced flap (CAF) is considered the gold standard therapy against which alternative therapies are generally compared. When evaluating these therapies, in addition to traditional measures of root coverage, subject-reported, qualitative measures of esthetics, pain, and overall preferences for alternative procedures should also be considered. This study determines if a xenogeneic collagen matrix (CM) with CAF might be as effective as CTG+CAF in the treatment of recession defects.
This study was a single-masked, randomized, controlled, split-mouth study of dehiscence-type recession defects in contralateral sites; one defect received CTG+CAF and the other defect received CM+CAF. A total of 25 subjects (8 male, 17 female; mean age: 43.7 +/- 12.2 years) were evaluated at 6 months and 1 year. The primary efficacy endpoint was recession depth at 6 months. Secondary endpoints included traditional periodontal measures, such as width of keratinized tissue and percentage of root coverage. Subject-reported values of pain, discomfort, and esthetic satisfaction were also recorded.
At 6 months, recession depth was on average 0.52 mm for test sites and 0.10 mm for control sites. Recession depth change from baseline was statistically significant between test and control, with an average of 2.62 mm gained at test sites and 3.10 mm gained at control sites for a difference of 0.4 mm (P = 0.0062). At 1 year, test percentage of root coverage averaged 88.5%, and controls averaged 99.3% (P = 0.0313). Keratinized tissue width gains were equivalent for both therapies and averaged 1.34 mm for test sites and 1.26 mm for control sites (P = 0.9061). There were no statistically significant differences between subject-reported values for esthetic satisfaction, and subjects' assessments of pain and discomfort were also equivalent.
When balanced with subject-reported esthetic values and compared to historical root coverage outcomes reported by other investigators, CM+CAF presents a viable alternative to CTG+CAF, without the morbidity of soft tissue graft harvest.
对于根覆盖治疗,结缔组织移植(CTG)加冠向推进瓣(CAF)被认为是对抗替代疗法的金标准。在评估这些疗法时,除了根覆盖的传统测量外,还应考虑受试者报告的美学、疼痛和对替代程序的整体偏好的定性测量。本研究旨在确定异种胶原基质(CM)加 CAF 是否与 CTG+CAF 一样有效治疗退缩缺陷。
这是一项单盲、随机、对照、劈裂口的研究,研究对象为对侧部位的开瓣型退缩缺损;一个缺损部位接受 CTG+CAF 治疗,另一个缺损部位接受 CM+CAF 治疗。共有 25 名受试者(8 名男性,17 名女性;平均年龄:43.7 +/- 12.2 岁)在 6 个月和 1 年时进行了评估。主要疗效终点为 6 个月时的退缩深度。次要终点包括角化组织宽度和根覆盖率等传统牙周测量值。受试者报告的疼痛、不适和美学满意度值也被记录下来。
在 6 个月时,试验部位的退缩深度平均为 0.52mm,对照部位为 0.10mm。试验组和对照组的退缩深度从基线的变化具有统计学意义,试验组平均增加 2.62mm,对照组平均增加 3.10mm,差异为 0.4mm(P = 0.0062)。在 1 年时,试验组的根覆盖率平均为 88.5%,对照组平均为 99.3%(P = 0.0313)。两种治疗方法的角化组织宽度增加量相当,试验组平均为 1.34mm,对照组平均为 1.26mm(P = 0.9061)。受试者对美学满意度的报告值之间没有统计学上的显著差异,受试者对疼痛和不适的评估也相当。
当与受试者报告的美学价值平衡,并与其他研究者报告的历史根覆盖结果相比,CM+CAF 是 CTG+CAF 的可行替代方案,而不会产生软组织移植物采集的发病率。