Graduate Program in Dentistry, Department of Periodontology, Dental School, Federal Fluminense University, Niteroi, Rio de Janeiro, Brazil.
J Clin Periodontol. 2010 Jul;37(7):651-8. doi: 10.1111/j.1600-051X.2010.01582.x. Epub 2010 Jun 1.
The semilunar incision was introduced in oral surgery more than a century ago. The semilunar coronally re-positioned flap (SLCRF) is one of the variants of this procedure; however, no previous controlled clinical study has evaluated the SLCRF performed as originally described. The objective of the present study was to compare the clinical outcomes of the SLCRF and coronally advanced flap (CAF) procedure in the treatment of maxillary Miller class I recession (GR) defects.
Twenty-two patients, with 22 contra-lateral Miller class I GR defects, were randomly assigned to CAF or SLCRF. Clinical parameters assessed included recession height, width of keratinized tissue, probing depth, vertical clinical attachment level, visual plaque score and bleeding on probing. Clinical recordings were performed at baseline and 6 months later. Inter-measurements differences were analysed with a chi(2) or a paired t-test, with significance set at alpha<0.05.
Both flap designs were effective in obtaining and maintaining a coronal displacement of the gingival margin. The CAF resulted in clinical improvements significantly better than SLCRF for percentage of root coverage (RC), frequency of complete RC and gain in clinical attachment level. RC obtained in the immediate post-surgical period of SLCRF-treated sites was not maintained throughout the subsequent evaluations.
RC is significantly better with CAF compared with the original SLCRF technique in the treatment of shallow maxillary Miller class I GR defects.
半月形切口在口腔外科中已有一个多世纪的历史。半冠状复位瓣（SLCRF）是该手术的一种变体；然而，以前没有对照临床试验评估过按原始描述进行的 SLCRF。本研究的目的是比较 SLCRF 和冠状推进瓣（CAF）在治疗上颌 Miller Ⅰ类退缩（GR）缺损中的临床效果。
22 例患者，22 对侧上颌 Miller Ⅰ类 GR 缺损，随机分为 CAF 或 SLCRF 组。评估的临床参数包括退缩高度、角化组织宽度、探诊深度、垂直临床附着水平、菌斑视觉评分和探诊出血。在基线和 6 个月后进行临床记录。采用卡方检验或配对 t 检验分析组内差异，以 α<0.05 为显著性水平。
两种瓣设计均能有效获得并维持牙龈边缘的冠状移位。CAF 比 SLCRF 在获得根面覆盖率（RC）百分比、完全 RC 的频率和临床附着水平增加方面的临床改善更为显著。SLCRF 治疗部位在即刻术后获得的 RC 在随后的评估中并未维持。
在治疗浅层上颌 Miller Ⅰ类 GR 缺损时，CAF 比原始 SLCRF 技术获得的 RC 明显更好。
