Dandu Shruti Raju, Murthy K Raja
Int J Periodontics Restorative Dent. 2016 Mar-Apr;36(2):231-7. doi: 10.11607/prd.2533.
The objective of this study was to clinically evaluate and compare the efficacy of the vestibular incision subperiosteal tunnel access (VISTA) technique using Bio-Gide (Geistlich) membrane enhanced with GEM 21S (Osteohealth) with periosteal pedicle graft (PPG) using a coronally advanced flap. Multiple gingival recession sites in 15 individuals were randomly assigned either to experimental site A (VISTA) or experimental site B (PPG) in a split-mouth design. The clinical parameters were recorded at baseline and 9 months postoperatively. Repeated measures analysis of variance with post hoc Bonferroni correction and paired t test were used to assess statistical significance (P < .05). Mean recession depth significantly decreased from 4.21 ± 1.08 mm (presurgery) to 0.61 ± 0.92 mm (9 months) with VISTA (87.37 ± 17.78% root coverage) and from 4.17 ± 1.18 mm (presurgery) to 1.16 ± 0.92 mm (9 months) with PPG (71.84 ± 19.25% root coverage). Width of keratinized tissue and clinical attachment gain were significantly higher in the VISTA group compared with the PPG group. Within the limits of the study both VISTA and PPG groups resulted in a significant amount of root coverage. The VISTA technique was less invasive and required minimal time and clinical maneuvering. It also resulted in a superior esthetic outcome.
本研究的目的是通过冠向推进瓣,对使用GEM 21S(Osteohealth)增强的Bio-Gide(Geistlich)膜的前庭切口骨膜下隧道入路(VISTA)技术与骨膜蒂移植(PPG)的疗效进行临床评估和比较。采用分口设计,将15名个体的多个牙龈退缩部位随机分配至实验部位A(VISTA)或实验部位B(PPG)。在基线和术后9个月记录临床参数。采用重复测量方差分析并进行事后Bonferroni校正和配对t检验来评估统计学意义(P <.05)。使用VISTA时,平均退缩深度从术前的4.21±1.08 mm显著降至9个月时的0.61±0.92 mm(牙根覆盖率为87.37±17.78%),使用PPG时,从术前的4.17±1.18 mm降至9个月时的1.16±0.92 mm(牙根覆盖率为71.84±19.25%)。与PPG组相比,VISTA组的角化组织宽度和临床附着增加显著更高。在本研究的范围内,VISTA组和PPG组均导致了大量的牙根覆盖。VISTA技术侵入性较小,所需时间和临床操作最少。它还产生了更好的美学效果。