Pini-Prato Giovanpaolo, Magnani Cristina, Zaheer Faizan, Rotundo Roberto, Buti Jacopo
Private Practice, Florence, Italy.
School of Dentistry, University of Manchester, Manchester, UK.
J Clin Periodontol. 2015 Jun;42(6):567-74. doi: 10.1111/jcpe.12407. Epub 2015 Jun 5.
To explore the influence of inter-dental tissues and root surface condition on complete root coverage following surgical treatment of gingival recessions.
Three hundred and eighty-six single recessions treated over 28 years were assessed. Patient-level and periodontal variables, presence/loss of inter-dental tissues, and presence/absence of non-carious cervical lesions (NCCLs) were recorded. Root coverage was assessed 1-year post-surgery. Multilevel analysis was performed to identify predictors of CRC.
Based on type of root coverage procedure four patient groups were created: free gingival graft (FGG) (n = 116), coronally advanced flap (CAF) (n = 107), CAF+connective tissue graft (CTG) (n = 131), and guided tissue regeneration (GTR) (n = 32). Percentages of complete root coverage (CRC) were 18.1% for FGG, 35.5% for CAF, 35.1% for CAF+CTG, and 18.8% for GTR. There was an OR = 0.26 (p < 0.0001) of achieving CRC in cases with loss of inter-dental tissue compared with cases with no inter-dental tissue loss. Similarly, cases with presence of NCCL showed an OR = 0.28 (p < 0.0001) of achieving CRC compared with cases without a NCCL. FGG achieved less CRC then CAF+CTG (p = 0.0012; OR = 0.32).
NCCLs, just like inter-dental tissue loss, are significant negative prognostic factors in achieving CRC following root coverage procedures.
探讨牙间组织和牙根表面状况对牙龈退缩手术治疗后牙根完全覆盖的影响。
评估28年间治疗的386例单处牙龈退缩病例。记录患者水平和牙周变量、牙间组织的存在/缺失以及非龋性颈部病变(NCCL)的存在/缺失情况。术后1年评估牙根覆盖情况。进行多水平分析以确定完全牙根覆盖(CRC)的预测因素。
根据牙根覆盖手术类型创建了四组患者:游离龈瓣移植术(FGG)(n = 116)、冠向推进瓣术(CAF)(n = 107)、CAF + 结缔组织移植术(CTG)(n = 131)和引导组织再生术(GTR)(n = 32)。FGG的完全牙根覆盖(CRC)百分比为18.1%,CAF为35.5%,CAF + CTG为35.1%,GTR为18.8%。与无牙间组织丧失的病例相比,牙间组织丧失的病例实现CRC的比值比(OR) = 0.26(p < 0.0001)。同样,与无NCCL的病例相比,存在NCCL的病例实现CRC的OR = 0.28(p < 0.0001)。FGG实现的CRC低于CAF + CTG(p = 0.0012;OR = 0.32)。
与牙间组织丧失一样,NCCL是牙根覆盖手术后实现CRC的重要负面预后因素。