Chambrone Leandro, Tatakis Dimitris N
Unit of Basic Oral Investigation, School of Dentistry, El Bosque University, Bogota, Colombia.
School of Dentistry, Ibirapuera University, São Paulo, Brazil.
J Periodontol. 2016 Jul;87(7):796-808. doi: 10.1902/jop.2016.150625. Epub 2016 Feb 15.
This review aims to: 1) assess the long-term outcomes of untreated buccal gingival recession (GR) defects and the associated reported esthetic and functional alterations; and 2) evaluate which factors influence the progression/worsening of dental and periodontal tissue conditions of untreated GR defects.
Interventional and observational studies with duration of ≥24 months reporting outcomes from adult patients with localized or multiple GR defects not treated by root coverage or gingival augmentation procedures were considered eligible for inclusion. MEDLINE and EMBASE databases were searched for articles published through July 2015. Random-effects meta-analyses were performed comparing baseline versus most recent follow-up outcomes (i.e., number of patients with ≥1 GR and number of sites with GR).
Of 378 potentially eligible articles, eight (reporting six studies) met inclusion criteria. Of 1,647 GR defects with baseline and follow-up information, 78.1% experienced GR depth increase during the follow-up period, whereas the remaining experienced decrease or no change. Moreover, there was a 79.3% increase in the number of GR defects among the patients followed (i.e., new GR defects). Pooled estimates (data from four studies) showed significantly increased odds of recession development long term, regarding either number of patients (odds ratio 2.43; P = 0.03) or number of sites with GR (odds ratio 2.16; P = 0.0005).
Untreated recession defects in individuals with good oral hygiene have a high probability of progressing during long-term follow-up.
本综述旨在：1）评估未经治疗的颊侧牙龈退缩（GR）缺损的长期预后以及相关的美学和功能改变；2）评估哪些因素会影响未经治疗的GR缺损的牙齿和牙周组织状况的进展/恶化。
纳入干预性和观察性研究，研究对象为成年患者，有局限性或多发性GR缺损，未接受根面覆盖或牙龈增量手术，研究持续时间≥24个月。检索MEDLINE和EMBASE数据库，查找截至2015年7月发表的文章。进行随机效应荟萃分析，比较基线与最近随访结果（即有≥1处GR的患者数量和有GR的部位数量）。
在378篇可能符合条件的文章中，8篇（报告6项研究）符合纳入标准。在1647处有基线和随访信息的GR缺损中，78.1%在随访期间GR深度增加，其余的则减少或无变化。此外，随访患者中GR缺损数量增加了79.3%（即出现了新的GR缺损）。汇总估计（来自四项研究的数据）显示，从长期来看，无论是患者数量（比值比2.43；P = 0.03）还是有GR的部位数量（比值比2.16；P = 0.0005），退缩发展的几率都显著增加。
口腔卫生良好的个体中未经治疗的退缩缺损在长期随访中有很高的进展可能性。
