Lanzrein Carla, Guldener Kevin, Imber Jean-Claude, Katsaros Christos, Stähli Alexandra, Sculean Anton
Quintessence Int. 2020;51(9):710-719. doi: 10.3290/j.qi.a44808.
To evaluate the healing of multiple adjacent type 1 and 2 gingival recessions (RT1 and RT2) treated with the modified coronally advanced tunnel (MCAT) or the laterally closed tunnel (LCT) in conjunction with a cross-linked hyaluronic acid and subepithelial palatal connective tissue grafts.
Fifteen healthy patients exhibiting multiple adjacent mandibular or maxillary RT1 and RT2 of a depth of ≥ 2 mm, were treated with the MCAT or LCT in conjunction with cross-linked hyaluronic acid and subepithelial palatal connective tissue grafts. Results were assessed at baseline and after a minimum of 6 months. The primary outcome variable was root coverage. Esthetic outcomes were evaluated on photographs using the root coverage esthetic score.
Postoperative pain and discomfort were low and no complications occurred. Data analyses were performed at patient level. After a mean follow-up of 17 ± 5.4 months, statistically significant root coverage was obtained in all 15 cases (P < .0001). Complete root coverage was obtained in 3 out of 15 cases (20%). Root coverage amounted to > 95% in three patients, was between 90% and 95% in four patients, and reached 87.5% in another patient. In three further patients root coverage measured 75%, 77%, and 64.6%, respectively. Mean root coverage measured 85.1 ± 23.2%. Mean keratinized tissue width increased from 2.5 ± 1.0 mm to 3.7 ± 0.7 mm (P < .0001) from baseline to follow-up, while mean probing depth showed no statistically significant changes (1.3 ± 0.5 mm vs 1.5 ± 0.5 mm). The mean root coverage esthetic score was 7.9 ± 1.9, while in the three cases exhibiting complete root coverage, a maximum root coverage esthetic score (10) was given for all treated teeth.
Within their limits, the present results indicate that the described treatment approach may lead to predictable root coverage of multiple mandibular and maxillary RT1 and RT2.
评估采用改良冠向推进隧道术（MCAT）或侧向封闭隧道术（LCT）联合交联透明质酸和腭部上皮下结缔组织移植治疗多个相邻的1型和2型牙龈退缩（RT1和RT2）的愈合情况。
15例健康患者，其下颌或上颌存在多个相邻的深度≥2mm的RT1和RT2，接受了MCAT或LCT联合交联透明质酸和腭部上皮下结缔组织移植治疗。在基线期和至少6个月后评估结果。主要结局变量为牙根覆盖情况。使用牙根覆盖美学评分在照片上评估美学效果。
术后疼痛和不适程度较低，未发生并发症。在患者层面进行数据分析。平均随访17±5.4个月后，15例患者均获得了具有统计学意义的牙根覆盖（P<.0001）。15例中有3例（20%）实现了完全牙根覆盖。3例患者的牙根覆盖率>95%，4例患者的牙根覆盖率在90%至95%之间，另1例患者的牙根覆盖率达到87.5%。另外3例患者的牙根覆盖率分别为75%、77%和64.6%。平均牙根覆盖率为85.1±23.2%。从基线期到随访期，平均角化组织宽度从2.5±1.0mm增加到3.7±0.7mm（P<.0001），而平均探诊深度无统计学意义上的变化（1.3±0.5mm对1.5±0.5mm）。平均牙根覆盖美学评分为7.9±1.9，而在3例实现完全牙根覆盖的病例中，所有治疗牙齿的牙根覆盖美学评分均为满分（10分）。
在其局限性范围内，目前的结果表明，所描述的治疗方法可能会使多个下颌和上颌的RT1和RT2实现可预测的牙根覆盖。
