Beykent University, Faculty of Dentistry, Department of Periodontology, İstanbul, Turkey.
Gazi University, Faculty of Dentistry, Department of Periodontology, Ankara, Turkey.
J Appl Oral Sci. 2020 Mar 27;28:e20190236. doi: 10.1590/1678-7757-2019-0236. eCollection 2020.
This clinical trial sought to evaluate the clinical effectiveness of concentrated growth factor (CGF) and compare it with connective tissue graft (CTG) with coronally advanced flap (CAF) in the treatment of Miller Class I gingival recessions (GR).
This split-mouth study included 74 Miller Class I isolated (24 teeth) or multiple (50 teeth) GRs in 23 jaws of 19 patients. GRs were randomly treated using CGF (test group: 37 teeth; 12 teeth in isolated GRs, 25 teeth in multiple GRs) or CTG with CAF (control group: 37 teeth;12 teeth isolated GRs, 25 teeth in multiple GRs). Clinical variables, plaque index (PI), gingival index (GI), probing depth (PD), recession depth (RD), recession width (RW), clinical attachment level (CAL), keratinized tissue thickness (KTT), keratinized tissue width (KTW), and root coverage (RC) were assessed at the baseline as well as at three and six months post-surgery. Healing index (HI) were obtained in the second and third weeks post-surgery. Postoperative pain was assessed for the first seven days using a horizontal visual analog scale (VAS).
No significant change was observed in PI, GI, or PD values in either the intergroup or the intragroup comparisons. A statistically significant decrease was observed in CAL, RD, and RW, and KTT increased in all groups at three and six months compared with the baseline. The control group had greater increases in KTW, KTT, and RC at three and six months. No significant difference was found in CAL or RD at the third and sixth months between the two groups. Healing was found to be similar for both groups in the second and third weeks post-surgery. The VAS values in the control group were higher than in the test group, especially at the second, fourth, fifth, and seventh days postoperatively.
CTG is superior to CGF with CAF for increasing KTT, KTW, and RC. CGF may be preferable due to decreased postoperative pain.
本临床试验旨在评估浓缩生长因子(CGF)的临床效果,并将其与带冠向推进瓣(CAF)的结缔组织移植物(CTG)治疗Miller Ⅰ类牙龈退缩(GR)进行比较。
本研究采用分口设计,纳入了 23 名患者的 74 个 Miller Ⅰ类孤立(24 颗牙)或多颗(50 颗牙)GR。GR 随机采用 CGF(实验组:37 颗牙;孤立 GR 12 颗,多颗 GR 25 颗)或 CTG 联合 CAF(对照组:37 颗牙;孤立 GR 12 颗,多颗 GR 25 颗)治疗。基线时及术后 3 个月和 6 个月评估临床变量,包括菌斑指数(PI)、牙龈指数(GI)、探诊深度(PD)、退缩深度(RD)、退缩宽度(RW)、临床附着水平(CAL)、角化组织厚度(KTT)、角化组织宽度(KTW)和根面覆盖(RC)。术后第 2 周和第 3 周记录愈合指数(HI)。术后 7 天采用水平视觉模拟量表(VAS)评估术后疼痛。
两组间及组内比较,PI、GI 或 PD 值均无显著变化。与基线相比,所有组在术后 3 个月和 6 个月时 CAL、RD 和 RW 均显著降低,KTT 增加。与基线相比,对照组在术后 3 个月和 6 个月时 KTW、KTT 和 RC 增加更为显著。两组在术后 3 个月和 6 个月时 CAL 或 RD 无显著差异。两组术后第 2 周和第 3 周愈合情况相似。对照组 VAS 值高于实验组,尤其是术后第 2、4、5 和 7 天。
与带 CAF 的 CTG 相比,CGF 更有利于增加 KTT、KTW 和 RC。CGF 术后疼痛较轻,可能是更好的选择。