Dwarakanath Chini Doraswamy, Divya Bheemavarapu, Sruthima Gottumukkala Naga Venkata Satya, Penmetsa Gautami Subadra
Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.
J Indian Soc Periodontol. 2016 Jul-Aug;20(4):435-440. doi: 10.4103/0972-124X.184033.
Gingival recession is a common condition and is more prevalent in smokers. It is widely believed that root coverage procedures in smokers result in less desirable outcome compared to nonsmokers', and there are few controlled studies in literature to support this finding. Therefore, the purpose of this study was to evaluate and compare the outcome of root coverage with sub-epithelial connective tissue graft (SCTG) in nonsmokers and smokers.
A sample of twenty subjects, 10 nonsmokers and 10 smokers were selected each with at least 1 Miller's Class I or II recession on a single rooted tooth. Clinical measurements of probing depth, clinical attachment level (CAL), gingival recession total surface area (GRTSA), depth of recession (RD), width of recession (RW), and width of keratinized tissue were determined at baseline, 3, and 6 months after surgery.
The treatment of gingival recession with SCTG and coronally advanced flap showed a decrease in the GRTSA, RD, RW, and an increase in CAL and width of keratinized gingiva in both the groups. However, the intergroup comparison of the clinical parameters showed no statistical significance. About 6 out of 10 nonsmokers (60%) and 3 smokers (30%) showed complete root coverage. The mean percentage of root coverage of 71.2% in nonsmokers and 38% in smokers was observed.
The results of the present study suggest that smoking may negatively influence gingival recession reduction and CAL gain. In addition, smokers may exhibit fewer chances of complete root coverage. Overall, nonsmokers showed better improvements in all the parameters compared to smokers at the end of 6 months.
牙龈退缩是一种常见病症,在吸烟者中更为普遍。人们普遍认为,与不吸烟者相比,吸烟者进行牙根覆盖手术的效果较差,而文献中几乎没有对照研究来支持这一发现。因此,本研究的目的是评估和比较非吸烟者和吸烟者采用上皮下结缔组织移植(SCTG)进行牙根覆盖的效果。
选取20名受试者作为样本,其中10名非吸烟者和10名吸烟者,每人单根牙上至少有一处Miller I类或II类牙龈退缩。在基线、术后3个月和6个月时,测定探诊深度、临床附着水平(CAL)、牙龈退缩总表面积(GRTSA)、退缩深度(RD)、退缩宽度(RW)和角化组织宽度等临床指标。
两组采用SCTG和冠向推进瓣治疗牙龈退缩后,GRTSA、RD、RW均减小,CAL和角化牙龈宽度均增加。然而,两组临床参数的组间比较无统计学意义。10名非吸烟者中有6名(60%)、10名吸烟者中有3名(30%)实现了完全牙根覆盖。观察到非吸烟者的平均牙根覆盖百分比为71.2%,吸烟者为38%。
本研究结果表明,吸烟可能会对减少牙龈退缩和增加CAL产生负面影响。此外,吸烟者实现完全牙根覆盖的机会可能较少。总体而言,在6个月结束时,与吸烟者相比,非吸烟者在所有参数上的改善情况更好。