a Associate Laboratory of Clinical Research in Dentistry , Fluminense Federal University , Rio de Janeiro , Brazil.
b Department of Implantology , Brazilian Air Force, Odontoclínica de Aeronáutica Santos-Dumont. , Rio de Janeiro , Brazil.
Acta Odontol Scand. 2019 Aug;77(6):457-467. doi: 10.1080/00016357.2019.1588372. Epub 2019 Mar 21.
The aim of this systematic review (SR) was to evaluate the effects of xenogenic collagen matrix (XCM) on the outcomes of clinical treatments of patients with Miller class-I or -II gingival recessions. Articles that were published before March 2018 were electronically searched in four databases without any date or language restrictions and manually searched in regular journals and gray literature. The eligibility criteria comprised randomized controlled trials (RCTs) and prospective controlled trials with follow-up periods of 6 months or more that compared the performance of XCM in the treatment of Miller class-I or -II gingival recessions. This SR was registered in PROSPERO under number CRD42018106118. Nine RCTs published between 2010 and 2018 were included in this SR. The percentage of root coverage (RC) was significantly higher ( = .0003) when gingival recessions were treated with XCM when compared to coronally advanced flap (CAF) alone. In addition, the parameters of keratinized mucosa width (KMW) ( = .006) and gingival thickness (GT) ( = .0003) were also improved when the XCM was used in comparison to the CAF alone. There was not a statistically significant difference ( = .22) between the clinical attachment level (CAL) achieved with the use of XCM and that achieved with CAF alone. RC with the use of XCM, when compared to connective tissue grafts (CTGs) ( = .09) and enamel matrix derivative (EMD) ( = .62), there was no significant difference; however, XCM yielded lower RC than CTG in the treatment of Miller class-I or -II gingival recessions. Based on both the individual studies' outcomes and the pooled estimates, it can be concluded that the use of XCM improves the RC, KMW and GT in the treatment of gingival recessions when compared to CAF alone and may be a viable alternative to use of CTG.
本系统评价(SR)的目的是评估异种胶原基质(XCM)对 Miller Ⅰ类或Ⅱ类牙龈退缩患者临床治疗效果的影响。在没有任何日期或语言限制的情况下,从四个数据库中对 2018 年 3 月之前发表的文章进行电子检索,并在常规期刊和灰色文献中进行手动检索。纳入标准包括比较 XCM 治疗 Miller Ⅰ类或Ⅱ类牙龈退缩效果的随机对照试验(RCT)和前瞻性对照试验,随访时间为 6 个月或以上。本 SR 在 PROSPERO 中以 CRD42018106118 号注册。本 SR 共纳入 2010 年至 2018 年发表的 9 项 RCT。与单独使用冠向复位瓣(CAF)相比,XCM 治疗牙龈退缩时的根覆盖百分比(RC)显著更高( = .0003)。此外,与单独使用 CAF 相比,角化黏膜宽度(KMW)( = .006)和牙龈厚度(GT)( = .0003)参数也得到改善。与单独使用 CAF 相比,XCM 获得的临床附着水平(CAL)差异无统计学意义( = .22)。与使用结缔组织移植物(CTG)( = .09)和釉基质衍生物(EMD)( = .62)相比,XCM 治疗效果无显著差异;然而,在治疗 Miller Ⅰ类或Ⅱ类牙龈退缩时,XCM 获得的 RC 低于 CTG。基于个体研究结果和汇总估计,可得出结论,与单独使用 CAF 相比,XCM 可提高 RC、KMW 和 GT,可作为 CTG 的替代选择。