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外源性胶原基质和/或牙釉基质衍生物治疗局限性牙龈退缩:一项随机临床试验。第二部分:患者报告的结果。

Xenogenous Collagen Matrix and/or Enamel Matrix Derivative for Treatment of Localized Gingival Recessions: A Randomized Clinical Trial. Part II: Patient-Reported Outcomes.

机构信息

Department of Prosthesis and Periodontology, Division of Periodontics, Piracicaba Dental School, State University of Campinas, Campinas, Brazil.

Department of Diagnosis and Surgery, Division of Periodontics, State University of São Paulo Campus, São José dos Campos, Brazil.

出版信息

J Periodontol. 2017 Dec;88(12):1319-1328. doi: 10.1902/jop.2017.170127. Epub 2017 Jul 28.

DOI:10.1902/jop.2017.170127
PMID:28753098
Abstract

BACKGROUND

Gingival recession (GR) might be associated with patient discomfort due to cervical dentin hypersensitivity (CDH) and esthetic dissatisfaction. The aim is to evaluate the effect of root coverage procedure with a xenogenous collagen matrix (CM) and/or enamel matrix derivative (EMD) in combination with a coronally advanced flap (CAF) on CDH, esthetics, and oral health-related quality of life (OHRQoL) of patients with GR.

METHODS

Sixty-eight participants with single Miller Class I/II GRs were treated with CAF (n = 17), CAF + CM (n = 17), CAF + EMD (n = 17), and CAF + CM + EMD (n = 17). CDH was assessed by evaporative stimuli using a visual analog scale (VAS) and a Schiff scale. Esthetics outcome was assessed with VAS and the Questionnaire of Oral Esthetic Satisfaction. Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to assess OHRQoL. All parameters were evaluated at baseline and after 6 months.

RESULTS

Intragroup analysis showed statistically significant reduction in CDH and esthetic dissatisfaction with no intergroup significant differences (P >0.05). The impact of oral health on QoL after 6 months was significant for CAF + CM, CAF + EMD, and CAF + CM + EMD (P <0.05). Total OHIP-14 score and psychologic discomfort, psychologic disability, social disability, and handicap dimensions showed negative correlation with esthetics. OHIP-14 physical pain dimension had positive correlation with CDH (P <0.05). OHIP-14 showed no correlation with percentage of root coverage, keratinized tissue width, or keratinized tissue thickness (P >0.05).

CONCLUSION

Root coverage procedures improve patient OHRQoL by impacting on a wide range of dimensions, perceived after reduction of CDH and esthetic dissatisfaction of patients with GRs treated with CAF + CM, CAF + EMD, and CAF + CM + EMD.

摘要

背景

牙龈退缩(GR)可能会因牙颈部牙本质过敏(CDH)和美学不满而引起患者不适。目的是评估使用异种胶原基质(CM)和/或釉基质衍生物(EMD)联合冠向推进瓣(CAF)进行根覆盖程序对 CDH、美学和与口腔健康相关的生活质量(OHRQoL)的影响患有 GR 的患者。

方法

68 名患有单 Miller Ⅰ/Ⅱ类 GR 的患者接受 CAF(n = 17)、CAF + CM(n = 17)、CAF + EMD(n = 17)和 CAF + CM + EMD(n = 17)治疗。使用视觉模拟量表(VAS)和 Schiff 量表评估 CDH 采用蒸发刺激。美学结果通过 VAS 和口腔美学满意度问卷进行评估。使用口腔健康影响简表-14(OHIP-14)问卷评估 OHRQoL。所有参数均在基线和 6 个月后进行评估。

结果

组内分析显示 CDH 和美学不满均有统计学显著降低,且组间无显著差异(P >0.05)。CAF + CM、CAF + EMD 和 CAF + CM + EMD 治疗 6 个月后,口腔健康对生活质量的影响具有统计学意义(P <0.05)。OHIP-14 总分和心理不适、心理残疾、社会残疾和障碍维度与美学呈负相关。OHIP-14 身体疼痛维度与 CDH 呈正相关(P <0.05)。OHIP-14 与根覆盖率、角化组织宽度或角化组织厚度无相关性(P >0.05)。

结论

根覆盖程序通过影响广泛的维度来改善患者的 OHRQoL,这些维度在治疗 GR 患者的 CAF + CM、CAF + EMD 和 CAF + CM + EMD 后降低 CDH 和患者的美学不满时被感知。

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