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采用前庭切口骨膜下隧道入路联合或不联合富血小板纤维蛋白治疗多处牙龈退缩——病例系列

Multiple Gingival Recession Coverage Treated with Vestibular Incision Subperiosteal Tunnel Access Approach with or without Platelet-Rich Fibrin - A Case Series.

作者信息

Garg Surbhi, Arora Sachit Anand, Chhina Shivjot, Singh Padam

机构信息

Department of Periodontics, ITS Dental College, Greater Noida, Uttar Pradesh, India.

出版信息

Contemp Clin Dent. 2017 Jul-Sep;8(3):464-468. doi: 10.4103/ccd.ccd_142_17.

DOI:10.4103/ccd.ccd_142_17
PMID:29042736
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5644008/
Abstract

BACKGROUND

Gingival recession involves both soft tissue and hard tissue loss. In this evolutionary era of dentistry, newer techniques have evolved for complete coverage of isolated recession defects. Since 2012, vestibular incision subperiosteal tunnel access (VISTA) technique was used with various regenerative membranes to treat multiple recession defects (MRDs). Platelet-rich fibrin (PRF) membrane, a pool of growth factors but have any added advantage to recession coverage techniques is controversial. Thus, in this case series, we compare the effect of VISTA with or without PRF-membrane for the treatment of Classes I and III MRDs.

SUBJECTS AND METHODS

Four patients between of age 30 and 40 years (two patients having bilateral Class I and another two having bilateral Class III MRDs) were selected from the Department of Periodontics, ITS Dental College, Greater Noida and designated as Case I-IV simultaneously. Recession defects at antagonist sites in each patient were corrected by VISTA approach with or without PRF-membrane. Recorded clinical parameters included recession depth, recession width, pocket probing depth, and clinical attachment level (CAL) at baseline and 6 months postoperatively.

RESULTS

Patients having Class I recession defects showed almost complete root coverage with VISTA technique alone and reflected no added advantage of PRF-membrane. However, patients with Class III recession defects treated with VISTA + PRF-membrane showed more reduction in recession depth and gain in CAL as compared to sites treated with VISTA only.

CONCLUSION

VISTA alone is a convenient technique for treatment of Class I MRDs. Addition of PRF-membrane for Class III recession defects give better outcome in term of reduction of recession depth and gain in CAL 6 month postoperatively.

摘要

背景

牙龈退缩涉及软组织和硬组织的丧失。在牙科的这个发展时代,已经出现了更新的技术来完全覆盖孤立的退缩性缺损。自2012年以来,前庭切口骨膜下隧道入路(VISTA)技术与各种再生膜一起用于治疗多个退缩性缺损(MRD)。富含血小板的纤维蛋白(PRF)膜含有大量生长因子,但对于退缩覆盖技术是否具有任何额外优势存在争议。因此,在本病例系列中,我们比较了使用或不使用PRF膜的VISTA治疗I类和III类MRD的效果。

受试者与方法

从大诺伊达ITS牙科学院牙周病科选取4名年龄在30至40岁之间的患者(2名患者患有双侧I类MRD,另外2名患有双侧III类MRD),并同时指定为病例I-IV。每位患者对颌位点的退缩性缺损通过使用或不使用PRF膜的VISTA方法进行矫正。记录的临床参数包括基线时和术后6个月时的退缩深度、退缩宽度、袋探诊深度和临床附着水平(CAL)。

结果

患有I类退缩性缺损的患者仅使用VISTA技术就显示出几乎完全的牙根覆盖,并且未显示PRF膜有额外优势。然而,与仅使用VISTA治疗的位点相比,使用VISTA + PRF膜治疗的III类退缩性缺损患者的退缩深度减少更多,CAL增加更多。

结论

单独使用VISTA是治疗I类MRD的便捷技术。对于III类退缩性缺损添加PRF膜在术后6个月时在减少退缩深度和增加CAL方面能产生更好的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/42a952f355b0/CCD-8-464-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/86aded199255/CCD-8-464-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/b5099253358e/CCD-8-464-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/be9595df989c/CCD-8-464-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/469a5ec16276/CCD-8-464-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/42a952f355b0/CCD-8-464-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/86aded199255/CCD-8-464-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/b5099253358e/CCD-8-464-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/be9595df989c/CCD-8-464-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/469a5ec16276/CCD-8-464-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b96/5644008/42a952f355b0/CCD-8-464-g007.jpg

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Use of Platelet-Rich Fibrin Membrane in the Treatment of Gingival Recession: A Systematic Review and Meta-Analysis.富血小板纤维蛋白膜在牙龈退缩治疗中的应用:一项系统评价与荟萃分析。
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Minimally invasive treatment of gingival recession by vestibular incision subperiosteal tunnel access technique with collagen membrane and advanced platelet-rich fibrin: A 6-month comparative clinical study.
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[Vestibular incision subperiosteal tunnel access with connective tissue graft for the treatment of Miller classI and II gingival recession].[前庭切口骨膜下隧道入路联合结缔组织移植治疗Miller I类和II类牙龈退缩]
Beijing Da Xue Xue Bao Yi Xue Ban. 2019 Feb 18;51(1):80-85. doi: 10.19723/j.issn.1671-167X.2019.01.015.
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Re: "Clinical evaluation of a modified coronally advanced flap alone or in combination with a platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: a 6-month study".回复:“单独使用改良冠向推进瓣或联合富血小板纤维蛋白膜治疗相邻多个牙龈退缩的临床评估:一项为期6个月的研究”
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Tunneling procedure for root coverage using acellular dermal matrix: a case series.使用脱细胞真皮基质进行根面覆盖的隧道技术:病例系列
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