Pundir Aena Jain, Agrawal Vandita, Pundir Siddharth, Diwan Vikas, Bodhi Sonika
Department of Periodontology, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India.
Department of Oral and Maxillofacial Pathology, Rungta College of Dental Sciences and Research.
Clin Adv Periodontics. 2016 Aug;6(3):118-126. doi: 10.1902/cap.2015.150060.
An amnion-chorion membrane is a placenta-derived tissue that has been introduced recently as a guided tissue regeneration membrane in dentistry. Numerous growth factors, proteins, and stem cell reserves in amnion could help in accelerated wound healing and regeneration, whereas chorion is a rich source of various collagen and non-collagen proteins. The present six-patient observational case series compares amnion and chorion allografts for recession coverage.
Six healthy adult patients presenting with 12 Miller Class I recession defects were treated surgically with a modified coronally advanced flap along with amniotic membrane (group A) or chorion (group B) for coverage of the recession defects following a split-mouth design. Clinical parameters measured at baseline, 3 months, and 6 months were width of keratinized gingiva (WKG), probing depth, recession height, clinical attachment level (CAL), and assessment of gingival biotype. Statistical analysis was done using paired and unpaired Student t test. The results showed statistically significant (P <0.01) improvements in all clinical parameters at the 3- and 6-month follow-ups in both groups. Nine of 12 treated recession defects showed 100% root coverage. The gingival biotype also showed a thick biotype in 10 sites that had an initial thin biotype.
Both amnion and chorion membranes provided promising results in terms of root coverage, increased WKG, CAL gain, and thickness of the gingival biotype and can be used for periodontal plastic surgeries.
羊膜 - 绒毛膜是一种源自胎盘的组织，最近已被引入牙科作为引导组织再生膜。羊膜中大量的生长因子、蛋白质和干细胞储备有助于加速伤口愈合和再生，而绒毛膜是各种胶原蛋白和非胶原蛋白的丰富来源。本六例患者的观察性病例系列比较了羊膜和绒毛膜同种异体移植物用于覆盖牙龈退缩的效果。
六名患有12处Miller I类牙龈退缩缺损的健康成年患者，采用改良的冠向推进瓣联合羊膜（A组）或绒毛膜（B组）进行手术治疗，采用分口设计覆盖牙龈退缩缺损。在基线、3个月和6个月时测量的临床参数包括角化龈宽度（WKG）、探诊深度、退缩高度、临床附着水平（CAL）以及牙龈生物型评估。使用配对和非配对学生t检验进行统计分析。结果显示，两组在3个月和6个月随访时所有临床参数均有统计学显著改善（P <0.01）。12处治疗的牙龈退缩缺损中有9处显示100%的牙根覆盖。牙龈生物型在10个初始为薄生物型的部位也显示为厚生物型。
羊膜和绒毛膜在牙根覆盖、增加WKG、获得CAL以及牙龈生物型厚度方面均取得了有前景的结果，可用于牙周整形手术。
