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富血小板纤维蛋白存在与否情况下的冠向推进瓣术治疗多个相邻牙龈退缩缺损:一项随机对照半口试验

Coronally advanced flap with and without platelet-rich fibrin in the treatment of multiple adjacent recession defects: A randomized controlled split-mouth trial.

作者信息

Potey Anushree Manohar, Kolte Rajashri Abhay, Kolte Abhay Pandurang, Mody Dhawal, Bodhare Girish, Pakhmode Resham

机构信息

Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India.

出版信息

J Indian Soc Periodontol. 2019 Sep-Oct;23(5):436-441. doi: 10.4103/jisp.jisp_387_18.

Abstract

BACKGROUND

The objective of our study was to evaluate and compare the effectiveness of coronally advanced flap (CAF) with or without the use of platelet-rich fibrin (PRF) membrane in the treatment of multiple adjacent recession defects (MARD) clinically and by cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

Twenty healthy patients having 75 MARD were allocated randomly to CAF with orthodontic button group (CAFB) or CAFB + PRF membrane group (CAFB + PRF). Clinical parameters such as gingival recession depth (GRD), probing depth (PD), and keratinized tissue width (KTW) were calculated at baseline, 3 months, and 6 months. The distance from the facial alveolar crest of bone to gingival margin bone and gingival thickness (GT) at three different points were assessed by CBCT at baseline and 6-month postsurgery. Esthetic outcome and postoperative discomfort were evaluated using root coverage esthetic score and visual analog scale, respectively.

RESULTS

Percent root coverage achieved in CAFB category was 93.17% ± 13.23% and that in CAFB + PRF group was 95.68% ± 10.13% at 6 months, with no notable difference. Similarly, no difference was found in either group in GRD reduction, PD, and CAL postoperatively. Use of PRF resulted in statistically highly significant ( < 0.001) increased GT at 6 months' time point as compared to participants treated with CAF without PRF, which indicates clinical and esthetic benefits achieved through the procedure.

CONCLUSIONS

CAFB can be used successfully to treat MARD with predictable outcome. Additional benefit in terms of gain in KTW and GT can be achieved when PRF membrane is used as an adjunct.

摘要

背景

我们研究的目的是通过临床和锥形束计算机断层扫描(CBCT)评估和比较使用或不使用富血小板纤维蛋白(PRF)膜的冠向推进瓣(CAF)治疗多个相邻牙龈退缩缺损(MARD)的有效性。

材料与方法

将20例患有75个MARD的健康患者随机分配至带正畸纽扣的CAF组(CAFB)或CAFB + PRF膜组(CAFB + PRF)。在基线、3个月和6个月时计算牙龈退缩深度(GRD)、探诊深度(PD)和角化组织宽度(KTW)等临床参数。在基线和术后6个月通过CBCT评估三个不同点处从牙槽嵴顶到牙龈缘骨的距离以及牙龈厚度(GT)。分别使用牙根覆盖美学评分和视觉模拟量表评估美学效果和术后不适。

结果

6个月时,CAFB组的牙根覆盖率为93.17%±13.23%,CAFB + PRF组为95.68%±10.13%,无显著差异。同样,两组术后GRD降低、PD和临床附着水平(CAL)均无差异。与未使用PRF的CAF治疗参与者相比,使用PRF在6个月时间点导致GT有统计学上的高度显著增加(<0.001),这表明该手术在临床和美学方面均有获益。

结论

CAFB可成功用于治疗MARD,且预后可预测。当使用PRF膜作为辅助手段时,在KTW和GT增加方面可获得额外益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/334b/6737843/ce84e685c454/JISP-23-436-g001.jpg

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