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结缔组织移植和引导组织再生根覆盖术后 20 年的结果。

Twenty-year results after connective tissue grafts and guided tissue regeneration for root coverage.

机构信息

Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt, Germany.

Private practice, Soest, Germany.

出版信息

J Periodontol. 2020 Mar;91(3):377-386. doi: 10.1002/JPER.19-0203. Epub 2019 Sep 19.

Abstract

BACKGROUND

Evaluation of clinical long-term results 20 years after connective tissue grafting (CTG) or guided tissue regeneration (GTR) using bioabsorbable barriers for root coverage therapy.

METHODS

Initially, 15 patients with 38 Miller Class I and II recession defects underwent CTG or GTR according to random assignment. At baseline, 3, 120 ± 12, and 240 ± 12 months after surgery, data on probing depth, clinical attachment level, recession depth and width, amount of keratinized tissue, and bleeding on probing were obtained. Additionally, patients' smoking habits and participation in supportive periodontal therapy were investigated.

RESULTS

Eight patients contributing 23 recessions were available at the 240 ± 12 months follow-up. Three and 120 ± 12 months after therapy with CTG, significantly better root coverage was observed compared with baseline (3 months: 3.01 ± 1.74 mm; P = 0.003; 120 ± 12 months: 2.11 ± 1.86 mm; P < 0.024). GTR resulted in significantly better root coverage compared with baseline after 3 months (2.25 ± 1.89 mm; P < 0.012). Although there were no significant changes in the recession depth between 3 and 240 ± 12 months in both groups (CTG: P = 0.097; GTR: P = 0.190), 1.57 ± 2.12 mm (CTG) and 1.19 ± 2.31 mm (GTR) of the achieved coverage after 3 months were lost. CTG showed significantly better relative root coverage percentage than GTR after 3 (P = 0.026) and 120 (P = 0.038) months. This study failed to detect a significant difference in the stability of root coverage after 240 ± 12 months between CTG and GTR (P = 0.448) and patients' assessments of their treatment outcomes (P = 0.503).

CONCLUSION

Long-term stability of root coverage and patient-perceived esthetic outcomes failed to show significant differences between CTG and GTR at 20 years post-surgery.

摘要

背景

采用可吸收屏障进行根覆盖治疗 20 年后,对结缔组织移植(CTG)或引导组织再生(GTR)的临床长期结果进行评估。

方法

最初,15 名患者的 38 个 Miller Ⅰ类和Ⅱ类退缩缺陷根据随机分配接受 CTG 或 GTR。在基线、3 个月、120±12 个月和 240±12 个月时,获取探诊深度、临床附着水平、退缩深度和宽度、角化组织量和探诊出血的数据。此外,还调查了患者的吸烟习惯和参与支持性牙周治疗的情况。

结果

8 名患者(23 个退缩)在 240±12 个月的随访中可用。与基线相比,CTG 治疗 3 个月和 120±12 个月后,根覆盖明显更好(3 个月:3.01±1.74mm;P=0.003;120±12 个月:2.11±1.86mm;P<0.024)。GTR 在 3 个月后与基线相比,根覆盖明显更好(2.25±1.89mm;P<0.012)。尽管两组在 3 个月和 240±12 个月之间,退缩深度没有明显变化(CTG:P=0.097;GTR:P=0.190),但在 3 个月后获得的覆盖中损失了 1.57±2.12mm(CTG)和 1.19±2.31mm(GTR)。与 GTR 相比,CTG 在 3 个月(P=0.026)和 120 个月(P=0.038)时的相对根覆盖率明显更高。本研究未发现 CTG 和 GTR 在 240±12 个月后根覆盖的稳定性之间存在显著差异(P=0.448),以及患者对治疗效果的评估(P=0.503)。

结论

在手术后 20 年,CTG 和 GTR 的根覆盖长期稳定性和患者感知的美学效果没有显示出显著差异。

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