Gholami Gholam Ali, Saberi Arezoo, Kadkhodazadeh Mahdi, Amid Reza, Karami Daryoosh
Department of Periodontics, Dental School, Shahid Beheshti Medical University, Evin, Iran.
Dent Res J (Isfahan). 2013 Jul;10(4):506-13.
Different techniques have been proposed for the treatment of gingival recession. The majority of current procedures use autogenous soft-tissue grafts, which are associated with morbidity at the donor sites. Acellular dermal matrix (ADM) Alloderm is an alternative donor material presented to reduce related morbidity and provide more volume of the donor tissue. This study aimed to evaluate the effectiveness of an ADM allograft for root coverage and to compare it with a connective tissue graft (CTG), when used with a double papillary flap.
Sixteen patients with bilateral class I or II gingival recessions were selected. A total of 32 recessions were treated and randomly assigned into the test and contralateral recessions into the control group. In the control group, the exposed root surfaces were treated by the placement of a CTG in combination with a double papillary flap; and in the test group, an ADM allograft was used as a substitute for palatal donor tissue. Probing depth, clinical attachment level, width of keratinized tissue (KT), recession height and width were measured before, and after 2 weeks and 6 months of surgery.
There were no statistically significant differences between the test and control groups in terms of recession reduction, clinical attachment gain, and reduction in probing depth. The control group had a statistically significant increased area of KT after 6 months compared to the test group.
ADM allograft can be considered as a substitute for palatal donor tissue in root coverage procedure.
已提出多种治疗牙龈退缩的技术。目前大多数手术使用自体软组织移植,这会导致供区出现并发症。脱细胞真皮基质(ADM)同种异体真皮是一种可供选择的供体材料,旨在减少相关并发症并提供更多的供体组织量。本研究旨在评估ADM同种异体移植用于牙根覆盖的有效性,并将其与结缔组织移植(CTG)在联合使用双乳头瓣时进行比较。
选择16例双侧I类或II类牙龈退缩患者。共治疗32处退缩,随机将一侧分配至试验组,对侧分配至对照组。对照组通过放置CTG联合双乳头瓣治疗暴露的牙根表面;试验组使用ADM同种异体移植替代腭部供体组织。在手术前、术后2周和6个月测量探诊深度、临床附着水平、角化组织(KT)宽度、退缩高度和宽度。
试验组和对照组在退缩减少、临床附着增加和探诊深度减少方面无统计学显著差异。与试验组相比,对照组在6个月后KT面积有统计学显著增加。
在牙根覆盖手术中,ADM同种异体移植可被视为腭部供体组织的替代品。