Barootchi Shayan, Tavelli Lorenzo, Ravidà Andrea, Wang Chin-Wei, Wang Hom-Lay
Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, 1011 North University Avenue, Ann Arbor, MI, 48109-1078, USA.
Clin Oral Investig. 2018 Nov;22(8):2727-2741. doi: 10.1007/s00784-018-2635-3. Epub 2018 Oct 6.
CAF in combination with a connective tissue graft (CTG) is considered the technique of choice for treating gingival recessions (GRs). Among the many recognized factors that can affect the outcomes, the use of chemical agents has been proposed. The effect of EDTA, as a commonly used agent, remains controversial. Therefore, the aim of this review was to assess the efficacy of EDTA root conditioning when combined to CAF + CTG.
A literature search was conducted to identify randomized clinical trials (RCTs) that performed CAF + CTG with and without EDTA for root coverage procedures. The following outcomes were assessed: recession reduction (Rec Red), complete root coverage (CRC), keratinized tissue gain (KT gain), clinical attachment level changes (CAL gain), and changes in pocket depth (PD changes).
Fourteen RCTs (575 GRs) were included and analyzed. Six articles were included in the EDTA group, with 8 in the non-EDTA group. Meta-analyses revealed statistically significant differences for the outcomes of Rec Red (3.68 mm versus 3.07 mm), CAL gain (4.15 mm versus 3.07 mm), and PD changes (- 0.44 mm versus 0.27 mm) in favor of the EDTA group, while outcomes of CRC (odds ratio of 1.15) and KT gain (1.98 mm versus 1.62 mm) were not significantly different.
Limited evidence is available when evaluating the effectiveness of EDTA root conditioning with CAF + CTG. However, the adjunct application of EDTA with CAF + CTG appears to be beneficial.
The adjunct application of EDTA may provide benefits when performing root coverage procedure via CAF + CTG.
游离龈瓣移植术（CAF）联合结缔组织移植术（CTG）被认为是治疗牙龈退缩（GR）的首选技术。在众多已确认的可能影响治疗结果的因素中，化学试剂的使用备受关注。乙二胺四乙酸（EDTA）作为一种常用试剂，其效果仍存在争议。因此，本综述的目的是评估EDTA根面处理联合CAF+CTG的疗效。
通过文献检索，确定采用CAF+CTG并使用或不使用EDTA进行根面覆盖手术的随机临床试验（RCT）。评估以下结果：退缩减少量（Rec Red）、完全根面覆盖（CRC）、角化组织增加量（KT gain）、临床附着水平变化（CAL gain）和牙周袋深度变化（PD changes）。
纳入并分析了14项RCT（575例GR）。EDTA组纳入6篇文章，非EDTA组纳入8篇。荟萃分析显示，在Rec Red（3.68mm对3.07mm）、CAL gain（4.15mm对3.07mm）和PD changes（-0.44mm对0.27mm）结果方面，EDTA组具有统计学显著差异，而CRC（优势比为1.15）和KT gain（1.98mm对1.62mm）结果无显著差异。
在评估EDTA根面处理联合CAF+CTG的有效性时，可用证据有限。然而，EDTA与CAF+CTG联合应用似乎是有益的。
在通过CAF+CTG进行根面覆盖手术时，EDTA的联合应用可能会带来益处。
