[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]
[Vestibular incision subperiosteal tunnel access with connective tissue graft for the treatment of Miller classI and II gingival recession].
作者信息
Fan K A, Zhong J S, Ouyang X Y, Xie Y, Chen Z Y, Zhou S Y, Zhang Y
机构信息
Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
出版信息
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.
OBJECTIVE
To evaluate the clinical outcomes of vestibular incision subperiosteal tunnel access (VISTA) with connective tissue graft (CTG) in the treatment of Miller classes I and II localized gingival recession.
METHODS
Ten patients with 10 Miller classes I and II localized gingival recessions were enrolled in the study. All defects were equal to or above 2 mm in recession depth. All the patients received treatment with VISTA+CTG. Their clinical parameters, including recession depth (Rec), recession width (RW), keratinized tissue width (KT), clinical attachment loss (CAL), probing depth (PD) were recorded and compared before surgery and 6 months later. The mean root coverage (MRC) and complete root coverage (CRC) were calculated at the end of 6 months. A visual analogue scale (VAS) was used to estimate the patients' discomfort during the operation and during the 2 weeks post-operation. Patient-based aesthetic satisfaction 6 months after surgery was evaluated by a VAS.
RESULTS
The mean Rec was (2.65±0.82) mm at baseline, and (0.35±0.58) mm after 6 months. The VISTA+CTG treatment resulted in an improvement of (2.30±0.98) mm in recession depth (P<0.001). MRC was 86.67%±21.94% and CRC reached 70% at the end of 6 months. KT increased (0.90±1.22) mm (P<0.05). Aesthetic satisfaction on the patients' level was 8.30 based on VAS (0=unsatisfied, 10=extremely satisfied). The patients' discomfort during the operation and 2 weeks post operation were 2.40 and 4.30 (0=no pain, 10=extreme pain). Furthermore, clinical outcomes showed no statistically significant difference between the gingival biotypes, and between the teeth positioned in maxillary and in mandibular.
CONCLUSION
VISTA+CTG could be an effective treatment for Miller classes I and II localized gingival recession. Clinical outcomes indicated decrease in recession depth and width, and increase in width of keratinized tissue. Patients suffered little pain during the operation and 2 weeks post-operation of healing and accessed good aesthetic satisfaction. VISTA+CTG could be an option for the treatment of Miller classes I and II localized gingival recession.
目的
评估前庭切口骨膜下隧道入路（VISTA）联合结缔组织移植（CTG）治疗米勒I类和II类局限性牙龈退缩的临床效果。
方法
纳入10例患有10处米勒I类和II类局限性牙龈退缩的患者。所有缺损的退缩深度均等于或大于2mm。所有患者均接受VISTA+CTG治疗。记录并比较术前及术后6个月的临床参数，包括退缩深度（Rec）、退缩宽度（RW）、角化组织宽度（KT）、临床附着丧失（CAL）、探诊深度（PD）。在6个月末计算平均牙根覆盖（MRC）和完全牙根覆盖（CRC）。使用视觉模拟量表（VAS）评估患者手术期间及术后2周的不适程度。通过VAS评估术后6个月患者的美学满意度。
结果
基线时平均Rec为（2.65±0.82）mm，6个月后为（0.35±0.58）mm。VISTA+CTG治疗使退缩深度改善了（2.30±0.98）mm（P<0.001）。6个月末MRC为86.67%±21.94%，CRC达到70%。KT增加了（0.90±1.22）mm（P<0.05）。基于VAS的患者美学满意度为8.30（0=不满意，10=极其满意）。患者手术期间及术后2周的不适程度分别为2.40和4.30（0=无疼痛，10=极度疼痛）。此外，临床效果在牙龈生物型之间以及上颌和下颌牙齿之间无统计学显著差异。
结论
VISTA+CTG可能是治疗米勒I类和II类局限性牙龈退缩的有效方法。临床效果表明退缩深度和宽度减小，角化组织宽度增加。患者在手术期间及术后2周愈合过程中疼痛轻微，美学满意度良好。VISTA+CTG可能是治疗米勒I类和II类局限性牙龈退缩的一种选择。
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