Honorary Associate Professor in Periodontology, UCL Eastman Dental Institute, London, UK.
Private Practice, Prato, Italy.
J Clin Periodontol. 2019 Oct;46(10):1013-1023. doi: 10.1111/jcpe.13168. Epub 2019 Aug 25.
To evaluate the superiority of coronally advanced flaps (CAFs) when used in combination with a xenogeneic collagen matrix (CMX) for root coverage of multiple adjacent gingival recessions.
Participants with at least 2 upper adjacent teeth exhibiting gingival recession depth ≥2 mm were recruited and randomized to CAF with (test) or without (control) CMX, respectively. Mean and complete root coverage, amount of keratinized tissue (KTw), gingival thickness (GThick) and patient-reported outcomes (PROMs) were recorded at baseline, 3, 6 and 12 months.
Twenty-four patients providing 61 gingival recessions were analysed. After 1 year, gingival recession depth decreased from 2.3 ± 0.7 to 0.3 ± 0.4 mm in the CAF + CMX group (2.0 ± 0.8 mm meanRC) and from 2.6 ± 1.0 to 0.6 ± 0.3 mm in the control group (2.0 ± 1.1 mm meanRC). No difference was observed between the two groups (p = 0.2023). Nineteen (63%) of the test and 16 (52%) of control defects showed complete root coverage (p = 0.4919). GThick greatly increased in the test group (0.5 mm; 0.2-0.8 mm, 95% CI; p = 0.0057). No difference between the two groups was observed for KTw (p = 0.5668) and PROMs.
At 1 year, CAF + CMX provided similar root coverage to CAF alone, but a significant increase in gingival thickness.
评估冠向推进瓣(CAF)联合异种胶原基质(CMX)在多个相邻牙龈退缩的根覆盖中的优势。
招募至少有 2 颗上颌相邻牙齿存在深度≥2mm 的牙龈退缩的患者,并随机分为 CAF 联合(试验组)或不联合(对照组)CMX 组。在基线、3、6 和 12 个月时记录平均和完全根覆盖、角化组织量(KTw)、牙龈厚度(GThick)和患者报告的结果(PROMs)。
24 名患者提供了 61 个牙龈退缩,进行了分析。1 年后,CAF+CMX 组的牙龈退缩深度从 2.3±0.7mm 降至 0.3±0.4mm(平均 RC 2.0±0.8mm),对照组从 2.6±1.0mm 降至 0.6±0.3mm(平均 RC 2.0±1.1mm)。两组间无差异(p=0.2023)。19 个(63%)试验组和 16 个(52%)对照组的缺陷完全覆盖(p=0.4919)。试验组 GThick 显著增加(0.5mm;0.2-0.8mm,95%CI;p=0.0057)。两组间 KTw(p=0.5668)和 PROMs 无差异。
1 年后,CAF+CMX 提供的根覆盖与单独 CAF 相似,但牙龈厚度显著增加。