Dixit Nisheet, Lamba Arundeep Kaur, Faraz Farrukh, Tandon Shruti, Aggarwal Kamal, Ahad Abdul
Department of Periodontics, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi, India.
Department of Periodontics, Dr. Ziauddin Ahmad Dental College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Indian J Dent Res. 2018 Sep-Oct;29(5):600-604. doi: 10.4103/ijdr.IJDR_22_17.
Marginal gingival recession can cause major functional and esthetic problems. Advanced flaps are the simplest, yet unpredictable procedures for managing these conditions. The predictability of root coverage can be increased by combining coronally advanced flap (CAF) or its modified approach with other regenerative techniques.
To ascertain the potential benefits of platelet-rich fibrin (PRF) on modified CAF for the treatment of gingival recession.
Study comprised of 12 patients with Millers' class I and class II gingival recession in two non-adjacent anterior teeth having a minimum 3 mm width of attached gingiva. Following split-mouth design, one tooth with gingival recession was subjected to modified CAF, while another was treated by CAF with PRF. The clinical parameters, i.e., plaque index, modified sulcular bleeding index, vertical gingival recession depth (VGRD), gingival recession width (GRW), clinical attachment level (CAL), and gingival thickness (GT) were recorded at baseline, 1 month, 3 months, and 6 months.
VGRD, GRW, CAL, and GT improved significantly from baseline to 1 month in both test and control groups. However, change in these parameters from 1 month to 3 months and 3 months to 6 months were statistically nonsignificant in both groups. On intergroup comparison, only the change in GT was found to be statistically significant (P < 0.05) at all three post-treatment visits.
Benefits of the combined technique in terms of increased GT appear to justify the use of PRF along with modified CAF for the treatment of mild to moderate gingival recessions.
边缘性牙龈退缩可导致严重的功能和美观问题。先进的皮瓣是治疗这些情况最简单但不可预测的方法。通过将冠向推进皮瓣(CAF)或其改良方法与其他再生技术相结合,可以提高牙根覆盖的可预测性。
确定富血小板纤维蛋白(PRF)对改良CAF治疗牙龈退缩的潜在益处。
研究纳入12例患有米勒I类和II类牙龈退缩的患者,其两颗非相邻前牙附着龈宽度至少为3mm。采用分口设计,一颗牙龈退缩的牙齿接受改良CAF治疗,另一颗则采用CAF联合PRF治疗。在基线、1个月、3个月和6个月时记录临床参数,即菌斑指数、改良龈沟出血指数、垂直牙龈退缩深度(VGRD)、牙龈退缩宽度(GRW)、临床附着水平(CAL)和牙龈厚度(GT)。
试验组和对照组从基线到1个月时,VGRD、GRW、CAL和GT均有显著改善。然而,两组从第1个月到第3个月以及从第3个月到第6个月这些参数的变化在统计学上无显著意义。组间比较发现,在所有三次治疗后随访中,仅GT的变化具有统计学意义(P < 0.05)。
联合技术在增加GT方面的益处似乎证明了PRF与改良CAF联合用于治疗轻至中度牙龈退缩的合理性。