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与牙龈退缩相关的非龋性颈病变:决策过程。

Non-carious cervical lesions associated with gingival recessions: a decision-making process.

机构信息

Department of Periodontology, School of Dentistry, Bologna University, Italy.

出版信息

J Periodontol. 2011 Dec;82(12):1713-24. doi: 10.1902/jop.2011.110080. Epub 2011 May 4.

Abstract

BACKGROUND

A method to predetermine the maximum root coverage level (MRC) was recently demonstrated to be reliable in predicting the position of the soft tissue margin after root coverage surgery. The aim of the present study is to suggest a decision-making process for treating non-carious cervical lesions (NCCLs) associated with gingival recessions based upon the topographic relationship between the MRC and NCCL and to assess patient and independent-periodontist esthetic evaluations.

METHODS

Five treatments were performed in 94 patients with NCCLs associated with a single gingival recession: 1) coronally advanced flap (CAF); 2) bilaminar procedure; 3) coronal odontoplasty plus restoration plus root odontoplasty plus CAF; 4) restoration plus CAF; and 5) restorative therapy. Clinical and esthetic evaluations made by the patient and an independent periodontist were done 1 year after treatments.

RESULTS

The satisfaction of the patient and periodontist with esthetics was very high in all NCCL treatments and Miller Class gingival recessions. The patient satisfaction and evaluation of root coverage and the periodontist evaluation of root coverage were statistically correlated with color-match evaluations and not with the amount of root coverage clinically achieved in each patient.

CONCLUSION

The proposed approaches provided good esthetic appearance and correct emergence profile for the great majority of NCCLs associated with gingival recessions.

摘要

背景

最近,一种预测根面覆盖术后软组织边缘位置的最大根面覆盖水平(MRC)预测方法已被证明是可靠的。本研究旨在根据 MRC 和非龋性颈缘缺损(NCCL)之间的拓扑关系,提出一种基于美学效果的治疗伴有牙龈退缩的 NCCL 的决策过程,并评估患者和独立牙周医生的美学评估。

方法

94 例伴有单个牙龈退缩的 NCCL 患者进行了 5 种治疗:1)冠向复位瓣(CAF);2)双层瓣;3)冠向牙体预备+修复体+根面牙体预备+CAF;4)修复体+CAF;5)修复治疗。治疗后 1 年,患者和独立牙周医生进行临床和美学评估。

结果

所有 NCCL 治疗和 Miller 分级的牙龈退缩患者对美学的满意度均非常高。患者对美学的满意度和根面覆盖的评估以及牙周医生对根面覆盖的评估与颜色匹配评估相关,而与每位患者临床获得的根面覆盖量无关。

结论

对于大多数伴有牙龈退缩的 NCCL,所提出的方法提供了良好的美学外观和正确的显露轮廓。

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