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黏膜下结缔组织瓣移植联合或不联合 enamel matrix derivative 治疗Miller Ⅰ类和Ⅱ类牙龈退缩的随机对照临床试验

Subepithelial connective tissue graft with or without enamel matrix derivative for the treatment of Miller class I and II gingival recessions: a controlled randomized clinical trial.

机构信息

Department of Periodontology, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Victor Babes 8, 400012, Cluj-Napoca, Romania.

出版信息

J Periodontal Res. 2013 Oct;48(5):563-72. doi: 10.1111/jre.12039. Epub 2013 Jan 14.

Abstract

BACKGROUND

The aim of this study was to evaluate whether the combination of enamel matrix derivative (EMD) with subepithelial connective tissue graft (SCTG) plus coronally advanced flap (CAF) would improve the treatment outcomes of Miller class I and II gingival recessions when compared with the same technique (SCTG plus CAF) alone.

METHODS

The study was designed as a randomized, parallel, controlled, double-blinded clinical trial. Forty-two patients were randomly assigned in the test group (SCTG plus EMD) and in the control group (SCTG). Patients had at least one gingival recession ≥ 2 mm. The clinical parameters were evaluated at baseline and at 14 d, 1, 3, 6 and 12 mo follow-up time points.

RESULTS

Forty-two patients, 21 in the test group (SCTG plus EMD) and 21 in the control group (SCTG), aged 21-48 years (mean age 31 ± 8.56) were initially included in the study. Both treatments, STCG plus EMD and SCTG, resulted in a significant final mean root coverage (2.91 ± 0.95mm and 2.91 ± 1.29 mm, respectively) (p < 0.001) and in a high mean percentage of root coverage (82.25 ± 22.20% and 89.75 ± 17.33%, respectively) (p < 0.001), 1 year after surgery. The differences in mean root coverage recorded for the two techniques after 1 year, were not statistically significant (p = 0.19). Complete root coverage was achieved in 56.5% of patients treated with SCTG plus EMD and in 70.6% of patients treated with SCTG (p = 0.275), 1 year after treatment.

CONCLUSIONS

The present study failed to demonstrate any additional clinical benefits when EMD was added to SCTG plus CAF.

摘要

背景

本研究旨在评估当与相同的技术(SCTG 加 CAF)相比时,将釉基质衍生物(EMD)与上皮下结缔组织移植物(SCTG)加冠向推进瓣(CAF)联合应用是否会改善 Miller 分类 I 和 II 型牙龈退缩的治疗效果。

方法

本研究设计为随机、平行、对照、双盲临床试验。42 名患者被随机分配到实验组(SCTG 加 EMD)和对照组(SCTG)。患者至少有一个牙龈退缩≥2mm。临床参数在基线和 14d、1、3、6 和 12 个月随访时间点进行评估。

结果

最初纳入研究的 42 名患者,21 名在实验组(SCTG 加 EMD),21 名在对照组(SCTG),年龄 21-48 岁(平均年龄 31±8.56)。SCTG 加 EMD 和 SCTG 治疗均导致显著的最终平均根覆盖率(分别为 2.91±0.95mm 和 2.91±1.29mm)(p<0.001)和高平均根覆盖率(分别为 82.25±22.20%和 89.75±17.33%)(p<0.001),手术后 1 年。两种技术在手术后 1 年记录的平均根覆盖率差异无统计学意义(p=0.19)。SCTG 加 EMD 治疗的患者中有 56.5%获得完全根覆盖,SCTG 治疗的患者中有 70.6%获得完全根覆盖(p=0.275),治疗后 1 年。

结论

本研究未能证明当 EMD 被添加到 SCTG 加 CAF 时会有任何额外的临床益处。

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