Department of Periodontology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
J Clin Periodontol. 2019 May;46(5):572-585. doi: 10.1111/jcpe.13106. Epub 2019 Apr 29.
To evaluate the long-term (≥2 years) stability of root coverage procedures for single gingival recessions.
A complete literature search was performed up to July 2018. Randomized controlled trials (RCTs) following ≥2 years were selected. Primary outcomes were complete root coverage (CRC) and mean root coverage (MRC). Secondary outcomes were width of keratinized tissue (KTW) and patient-centred parameters. Meta-analysis was conducted when possible.
A total of fifteen RCTs were included. The results demonstrated significantly higher MRC in short-term than long-term after coronally advanced flap (CAF; 7.29%, p = 0.006). When CAF combined with connective tissue graft (CTG), no significant difference was observed in CRC or MRC for short-term versus long-term (1.00, p = 0.97; 2.35%, p = 0.09), and it resulted in better long-term efficacy than CAF alone in terms of CRC (0.69, p = 0.0006) and KTW (-0.63 mm, p = 0.04). For CAF plus enamel matrix derivative, the meta-analysis showed no significant difference between the short-term and long-term results of CRC (1.26, p = 0.21).
CAF alone could result in decreased postoperative percentage of root coverage with time. CAF + CTG could maintain long-term stability and result in better root coverage outcomes than CAF.
评估单发性牙龈退缩的根覆盖程序的长期(≥2 年)稳定性。
截至 2018 年 7 月,进行了全面的文献检索。选择了随访时间≥2 年的随机对照试验(RCT)。主要结局为完全根覆盖(CRC)和平均根覆盖(MRC)。次要结局为角化组织宽度(KTW)和以患者为中心的参数。在可能的情况下进行了荟萃分析。
共纳入 15 项 RCT。结果表明,冠向推进瓣(CAF)短期的 MRC 明显高于长期(7.29%,p=0.006)。当 CAF 联合结缔组织移植物(CTG)时,短期与长期的 CRC 或 MRC 无显著差异(1.00,p=0.97;2.35%,p=0.09),且在 CRC(0.69,p=0.0006)和 KTW(-0.63mm,p=0.04)方面,其长期疗效优于 CAF 单独使用。对于 CAF 加釉基质衍生物,荟萃分析显示 CRC 的短期和长期结果之间无显著差异(1.26,p=0.21)。
单独使用 CAF 会随时间推移导致术后根覆盖百分比降低。CAF+CTG 可维持长期稳定性,并获得优于 CAF 的根覆盖效果。