Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Private Practice, Chicago, IL, USA.
J Clin Periodontol. 2019 Sep;46(9):937-948. doi: 10.1111/jcpe.13163. Epub 2019 Jul 19.
To evaluate the long-term outcomes of Acellular Dermal Matrix (ADM) with Coronally Advanced Flap (CAF) or Tunnel technique (TUN) in the treatment of multiple adjacent gingival recessions (MAGRs).
Nineteen of the original 24 patients contributing to a total number of 33 sites for CAF and 34 for TUN were available for the 12 years follow-up examination. Recession depth, mean root coverage (mRC), keratinized tissue width (KTW), gingival thickness (GT) were evaluated and compared with baseline values and 6-months results. Regression analysis was performed to identify factors related to the stability of the gingival margin.
A highly significant drop in mRC was observed for both groups from the 6 months timepoint to the 12 years recall (p < .001). While there were no statistically significant differences between the two groups in terms of Clinical Attachment Level (CAL), KTW, GT changes and Root Coverage Esthetic Score at each timepoint (p > .05). KTW ≥ 2 mm and GT ≥ 1.2 mm at 6-months were two predictors for stability of the gingival margin (p = .03 and p = .01, respectively).
A significant relapse of the gingival margin of MAGRs treated with CAF or TUN + ADM was observed after 12 years.
评估脱细胞真皮基质（ADM）联合冠向推进瓣（CAF）或隧道技术（TUN）治疗多发性邻面牙龈退缩（MAGR）的长期疗效。
24 名患者中的 19 名（共 33 个 CAF 位点和 34 个 TUN 位点）在 12 年的随访检查中可用于评估。评估并比较了退缩深度、平均根面覆盖率（mRC）、角化组织宽度（KTW）和牙龈厚度（GT），与基线值和 6 个月结果进行比较。采用回归分析确定与牙龈边缘稳定性相关的因素。
两组在 6 个月至 12 年随访期间 mRC 均显著下降（p<0.001）。两组在临床附着水平（CAL）、KTW、GT 变化和根覆盖美学评分方面，各时间点均无统计学差异（p>0.05）。6 个月时 KTW≥2mm 和 GT≥1.2mm 是预测牙龈边缘稳定性的两个因素（p=0.03 和 p=0.01）。
CAF 或 TUN+ADM 治疗 MAGR 后 12 年，牙龈边缘出现明显复发。
