Department of Periodontics, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas, TX 75246, USA.
J Periodontol. 2012 Jul;83(7):893-901. doi: 10.1902/jop.2011.110144. Epub 2011 Dec 8.
The objective of this case series is to compare root defect coverage results and healing responses of bilateral recession defects treated with acellular dermal matrix (ADM) with and without recombinant human platelet-derived growth factor (rhPDGF).
Seventeen patients with 40 bilateral gingival recession defects were compared. Each defect was ≥2 mm and treated with ADM and a coronally advanced flap. Using split-mouth design, the control-side ADM was hydrated in sterile saline, whereas the test-side ADM was hydrated in rhPDGF. The patients were evaluated at 1 week, 1 month, 3 months, and 6 months. Standardized measurements were taken preoperatively at 3 and 6 months. Healing was clinically assessed at 1 week and 1 month post-surgically.
Both test and control groups showed significant gain in root defect coverage over the 6-month period for all individuals, with the test group showing a 69.0% gain and the control group showing a 76.7% gain. Patients divided into Miller Class I and Class III defects were also found to have a significant gain in root defect coverage over 6 months. The test group showed 84.1% gain, and the control group showed 84.7% gain for Miller Class I defects. For Miller Class III defects, the test group showed 51.5% gain, and the control group showed a 60.8% gain. One week after surgery, 35% of the test group showed better healing, whereas 15% of the control group showed better healing. One month after surgery, 20% of the test group showed better healing, whereas 15% of the control group showed better healing.
Based on the results of this case series, there were no statistically or clinically significant differences in root defect coverage, keratinized tissue, clinical attachment level, or clinical healing for treatment of root recession with a coronally advanced flap and ADM with and without rhPDGF.
本病例系列的目的是比较使用脱细胞真皮基质 (ADM) 治疗双侧牙龈退缩缺损的根面缺陷覆盖结果和愈合反应，以及使用和不使用重组人血小板衍生生长因子 (rhPDGF) 的情况。
比较了 17 例有 40 个双侧牙龈退缩缺损的患者。每个缺损均≥2mm，采用 ADM 和冠向推进瓣治疗。采用分侧设计，对照侧 ADM 用无菌生理盐水水化，而试验侧 ADM 用 rhPDGF 水化。患者在术后 1 周、1 个月、3 个月和 6 个月进行评估。术前在 3 个月和 6 个月时进行标准化测量。术后 1 周和 1 个月进行临床愈合评估。
两组在所有个体中均在 6 个月内显示出根面缺陷覆盖的显著增加，试验组增加 69.0%，对照组增加 76.7%。将患者分为 Miller Ⅰ类和Ⅲ类缺损，也发现 6 个月内根面缺陷覆盖有显著增加。试验组增加 84.1%，对照组增加 84.7%。对于 Miller Ⅲ类缺损，试验组增加 51.5%，对照组增加 60.8%。术后 1 周，35%的试验组愈合较好，15%的对照组愈合较好。术后 1 个月，20%的试验组愈合较好，15%的对照组愈合较好。
根据本病例系列的结果，用冠向推进瓣和 ADM 治疗根面退缩，使用和不使用 rhPDGF 治疗，在根面缺陷覆盖、角化组织、临床附着水平和临床愈合方面，没有统计学或临床意义上的差异。
