Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Al. Octávio Pinheiro Brisolla 9-75, Bauru, SP, 17012-901, Brazil.
, Bauru, Brazil.
Clin Oral Investig. 2020 Mar;24(3):1197-1203. doi: 10.1007/s00784-019-02983-0. Epub 2019 Jul 12.
This study evaluated clinical outcomes of acellular dermal matrix (ADM) allograft compared with autogenous free gingival graft (FGG) for gingival augmentation after 15 years.
Twenty-two patients were originally included and evaluated by de Resende et al. (Clin Oral Investig 23:539-550, 2019), and 12 accepted to participate in this longitudinal evaluation. Clinical parameters evaluated were recession depth (RD), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), and soft tissue thickness (TT). In addition, esthetic perception was evaluated by patients and by a calibrated periodontist. Data were evaluated by ANOVA complemented by Tukey tests (p < 0.05).
After 15 years, both treatments provided a significant increase in KTW and TT but with superior results for the FGG group (p < 0.05). No differences were observed between groups for PD and CAL. In the ADM group, RD significantly increased in long term, as well as the rate of tissue contraction. The percentage of shrinkage for the ADM group was 59.6%. Conversely, the FGG group presented a creeping attachment of 17.6% and RD significantly decreased in long term. The ADM group presented superior results considering professional esthetic perception.
Both treatments longitudinally promoted significant gain of keratinized tissue width and thickness with superior outcomes for the FGG group. The ADM group demonstrated more tissue contraction and gingival recession whereas the FGG group presented creeping attachment. Professional esthetic perception was superior for the ADM group.
This study added important clinical data with long-term evaluation of ADM compared with FGG.
本研究评估了脱细胞真皮基质（ADM）同种异体移植物与自体游离龈移植（FGG）在 15 年后用于牙龈增量的临床效果。
最初有 22 名患者被 de Resende 等人纳入并进行评估（Clin Oral Investig 23:539-550, 2019），其中 12 名患者同意参与这项纵向评估。评估的临床参数包括龈退缩深度（RD）、探诊深度（PD）、临床附着水平（CAL）、角化组织宽度（KTW）和软组织厚度（TT）。此外，患者和一位经过校准的牙周病学家对美观感知进行了评估。数据采用方差分析（ANOVA）进行评估，并辅以 Tukey 检验（p<0.05）。
15 年后，两种治疗方法均显著增加了 KTW 和 TT，但 FGG 组的效果更优（p<0.05）。两组在 PD 和 CAL 方面无差异。ADM 组在长期内 RD 显著增加，同时组织收缩率也增加。ADM 组的收缩率为 59.6%。相反，FGG 组表现出 17.6%的附着龈迁移，长期 RD 显著减少。ADM 组在专业美观感知方面表现更佳。
两种治疗方法均在长期内显著增加了角化组织宽度和厚度，FGG 组的效果更优。ADM 组表现出更多的组织收缩和牙龈退缩，而 FGG 组则表现出附着龈迁移。专业美观感知方面 ADM 组更优。
本研究对 ADM 与 FGG 进行了长期比较，提供了重要的临床数据。
