Gupta Priyanka, Gupta Harinder
Department of Periodontics, Punjab Government Dental College, Amritsar, Punjab, India.
Indian J Dent. 2014 Oct;5(4):190-8. doi: 10.4103/0975-962X.144723.
The aim of this study is to compare and evaluate the clinical outcome of the envelope-type of coronally advanced flap (CAF) alone versus envelope type of coronally advanced flap plus type I collagen membrane (NEOMEM) in the treatment of multiple buccal gingival recessions, using the split mouth study.
Ten patients in the age group of 20-50 years showing bilateral gingival recessions were treated. The defects in each patient were randomly assigned as Group A, which were treated with the envelope type of CAF, and those in Group B were treated with envelope type of CAF along with the Type I collagen membrane (NEOMEM). The recession depth (RD), probing depth (PD), clinical attachment level (CAL), and width of the keratinized tissue (KT) were measured at baseline, at three and six month intervals.
Forty-six Miller's class I and II gingival recessions were treated. In the CAF + Type I collagen membrane (NEOMEM)-treated (Group B) sites the baseline gingival recession was 2.34 ± 0.48 mm, while in the CAFtreated (Group A) sites it was 2.52 ± 0.84 mm. Both the treatments resulted in significant recession depth reduction (P < 0.001), but the reduction was significantly greater (P < 0.01) for Group B than Group A. The probing depth changes were significant (P < 0.01) for both groups, but the difference was nonsignificant. Similarly, a significant gain of CAL was seen in Group B (2.23 ± 0.75 mm, P < 0.001) as well as in group A (1.60 ± 0.86 mm, P < 0.001) showing a significant difference (P < 0.01) between the two groups. The width of keratinized tissue was also significantly (P < 0.001) increased in both groups, but the increase was significantly greater (P < 0.001) in group B (2.30 ± 1.06 mm) than in group A (1.21 ± 0.67 mm).
The envelope type of CAF along with Type I collagen membrane (NEOMEM) was more effective than envelope type of CAF alone, in producing root coverage in multiple gingival recession defects, associated with gain in CAL as also in the width of KT.
本研究的目的是采用半口对照研究，比较和评估单纯信封式冠向复位瓣（CAF）与信封式冠向复位瓣联合I型胶原膜（NEOMEM）治疗多个颊侧牙龈退缩的临床效果。
对10例年龄在20 - 50岁之间出现双侧牙龈退缩的患者进行治疗。将每位患者的缺损随机分为A组，采用信封式CAF治疗；B组采用信封式CAF联合I型胶原膜（NEOMEM）治疗。在基线、每隔3个月和6个月时测量退缩深度（RD）、探诊深度（PD）、临床附着水平（CAL）和角化组织宽度（KT）。
共治疗了46处Miller I类和II类牙龈退缩。在接受CAF联合I型胶原膜（NEOMEM）治疗（B组）的部位，基线牙龈退缩为2.34±0.48mm，而在接受CAF治疗（A组）的部位为2.52±0.84mm。两种治疗方法均使退缩深度显著降低（P < 0.001），但B组的降低幅度显著大于A组（P < 0.01）。两组的探诊深度变化均显著（P < 0.01），但差异无统计学意义。同样，B组（2.23±0.75mm，P < 0.001）和A组（1.60±0.86mm，P < 0.001）的CAL均有显著增加，两组间差异显著（P < 0.01）。两组的角化组织宽度也均显著增加（P < 0.001），但B组（2.30±1.06mm）的增加幅度显著大于A组（1.21±0.67mm）（P < 0.001）。
信封式CAF联合I型胶原膜（NEOMEM）在治疗多个牙龈退缩缺损时，在实现牙根覆盖、增加CAL和KT宽度方面比单纯信封式CAF更有效。
