Department of Oral Surgery and Periodontology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil.
J Clin Periodontol. 2012 Apr;39(4):393-9. doi: 10.1111/j.1600-051X.2012.01851.x. Epub 2012 Feb 5.
The aim of this randomized controlled clinical study was to compare the use of an acellular dermal matrix graft (ADMG) with or without the enamel matrix derivative (EMD) in smokers to evaluate which procedure would provide better root coverage.
Nineteen smokers with bilateral Miller Class I or II gingival recessions ≥3 mm were selected. The test group was treated with an association of ADMG and EMD, and the control group with ADMG alone. Probing depth, relative clinical attachment level, gingival recession height, gingival recession width, keratinized tissue width and keratinized tissue thickness were evaluated before the surgeries and after 6 months. Wilcoxon test was used for the statistical analysis at significance level of 5%.
No significant differences were found between groups in all parameters at baseline. The mean gain recession height between baseline and 6 months and the complete root coverage favored the test group (p = 0.042, p = 0.019 respectively).
Smoking may negatively affect the results achieved through periodontal plastic procedures; however, the association of ADMG and EMD is beneficial in the root coverage of gingival recessions in smokers, 6 months after the surgery.
本随机对照临床试验的目的是比较脱细胞真皮基质移植物（ADMG）与或不与釉基质衍生物（EMD）在吸烟者中的应用，以评估哪种方法能提供更好的根覆盖。
选择了 19 名双侧 Miller Ⅰ类或Ⅱ类牙龈退缩≥3mm 的吸烟者。实验组采用 ADMG 和 EMD 联合治疗，对照组仅采用 ADMG 治疗。在手术前和术后 6 个月评估探诊深度、相对临床附着水平、牙龈退缩高度、牙龈退缩宽度、角化组织宽度和角化组织厚度。采用 Wilcoxon 检验进行统计学分析，显著性水平为 5%。
两组在基线时所有参数均无显著差异。与基线相比，6 个月时的平均牙龈退缩高度增加，完全根覆盖更有利于实验组（p=0.042，p=0.019）。
吸烟可能会对牙周整形手术后的结果产生负面影响；然而，在手术后 6 个月时，ADMG 和 EMD 的联合应用有利于吸烟者牙龈退缩的根覆盖。
