Sculean Anton, Cosgarea Raluca, Katsaros Christos, Arweiler Nicole Birgit, Miron Richard John, Deppe Herbert
Quintessence Int. 2017;48(10):777-782. doi: 10.3290/j.qi.a39031.
To clinically evaluate the outcomes following surgical coverage of single and multiple Miller Class I and III gingival recessions at crown-restored teeth in the esthetic area by means of the modified coronally advanced tunnel (MCAT).
Eight systemically healthy patients (5 females) with a total of 23 single or multiple maxillary Miller Class I or III gingival recessions were consecutively treated with MCAT in conjunction with a subepithelial connective tissue graft (SCTG). Out of the 23 recessions, 16 were classified as Miller Class I and seven as Miller Class III. All patients presented at least one facial gingival recession at a crown-restored tooth, located in the maxillary anterior area. In all cases, the facial recession was associated with an impaired esthetic appearance. Clinical measurements were made at baseline (immediately before reconstructive surgery) and at 12 months postoperatively. The primary outcome variable was complete root coverage (CRC) (ie, 100% root coverage).
Healing was uneventful in all cases. At 12 months, statistically highly significant (P < .0001) root coverage was obtained in all patients and defects. CRC was obtained in 22 out of the 23 recessions (in 16 Miller Class I and in six out of the seven Miller Class III recessions). In one Miller Class III recession, root coverage measured 89.10%. The treatment yielded a mean root coverage of 92.62% and 3.75 mm, respectively, and was associated with a mean gain of keratinized tissue width of 0.62 ± 1.15 mm (P < .05).
Within their limits, the present findings indicate that MCAT in conjunction with SCTG represents a valuable option for treating single and multiple gingival recessions at crown-restored teeth in the maxillary esthetic area thus avoiding the replacement of the prosthetic restorations.
通过改良冠向推进隧道术（MCAT）对美学区域中牙冠修复牙齿的单个和多个Miller I类和III类牙龈退缩进行手术覆盖后，进行临床疗效评估。
8例全身健康患者（5例女性），共有23个单个或多个上颌Miller I类或III类牙龈退缩，连续接受MCAT联合上皮下结缔组织移植术（SCTG）治疗。在这23个退缩中，16个被归类为Miller I类，7个为Miller III类。所有患者在上颌前部区域的牙冠修复牙齿处至少有一个面部牙龈退缩。在所有病例中，面部退缩均伴有美学外观受损。在基线（重建手术前即刻）和术后12个月进行临床测量。主要结局变量为完全牙根覆盖（CRC）（即100%牙根覆盖）。
所有病例愈合均顺利。术后12个月，所有患者和缺损处均获得了具有统计学高度显著性（P <.0001）的牙根覆盖。23个退缩中有22个获得了CRC（16个Miller I类和7个Miller III类退缩中的6个）。在1个Miller III类退缩中，牙根覆盖为89.10%。该治疗分别产生了平均92.62%的牙根覆盖和3.75 mm的牙根覆盖，并且角化组织宽度平均增加了0.62±1.15 mm（P <.05）。
在其适用范围内，本研究结果表明，MCAT联合SCTG是治疗上颌美学区域中牙冠修复牙齿的单个和多个牙龈退缩的一种有价值的选择，从而避免了修复体的更换。
