Mao Er-Jia
Dept. of Periodontics, School of Dentistry, University of Washington, Seattle WA 98195, USA;Periodontics Northwest, Seattle WA 98133, USA.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2018 Apr 1;36(2):117-122. doi: 10.7518/hxkq.2018.02.001.
The main purposes of periodontal graft surgery include achieving root coverage, improving the clinical attachment level and keratinized tissue, and advancing the procedure of periodontal plastic surgery. Autogenous graft, such as subepithelial connective tissue graft-based procedure, provide the best outcomes for mean and complete root coverage, as well as increase in keratinized tissue. However, a disadvantage of the procedure is in the location of the operation itself: the additional surgical site (palate). Therefore, clinicians are always looking for graft substitutes. This article will discuss the evidence supporting the use of 1) acellular dermal matrix (ADM); 2) xenogeneic collagen matrix (XCM); 3) recombinant human platelet-derived growth factor (rhPDGF); 4) enamel matrix derivative (EMD); 5) guided tissue regeneration (GTR); 6) living cellular construct (LCC), all of which are used in conjunction with coronally advanced flaps as alternatives to autogenous donor tissue. The decision tree for treatments of Miller recession-type defects are also discussed.
牙周移植手术的主要目的包括实现牙根覆盖、改善临床附着水平和角化组织，以及推进牙周整形手术进程。自体移植，如基于上皮下结缔组织移植的手术，在平均和完全牙根覆盖以及角化组织增加方面能提供最佳效果。然而，该手术的一个缺点在于手术部位本身：额外的手术区域（腭部）。因此，临床医生一直在寻找移植替代物。本文将讨论支持使用以下几种替代物的证据：1）脱细胞真皮基质（ADM）；2）异种胶原基质（XCM）；3）重组人血小板衍生生长因子（rhPDGF）；4）釉基质衍生物（EMD）；5）引导组织再生（GTR）；6）活细胞构建体（LCC），所有这些都与冠向推进瓣联合使用，作为自体供体组织的替代物。还将讨论米勒退缩型缺损治疗的决策树。
