Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
J Periodontol. 2021 Feb;92(2):254-262. doi: 10.1002/JPER.20-0310. Epub 2020 Aug 17.
The long-term outcomes of acellular dermal matrix (ADM) for the treatment of isolated gingival recessions has not yet been evaluated. Thus, the aim of this study was to observe the root coverage outcomes of coronally advanced flap with ADM over time, and compare them with their adjacent untreated sites.
Twelve patients (from 20) were available at the 9-year recall. Clinical parameters (recession depth, mean root coverage [mRC], keratinized tissue width [KTW], and gingival thickness) were evaluated and compared with the 1-year results, and the ADM-adjacent untreated sites (on mesial and distal) via mixed-modeling regression analyses.
From 1 to 9 years, the ADM-treated isolated recessions showed a relapse from 77% to 62% mRC (P <0.05). A similar pattern toward apical shift of the gingival margin was noticed for the ADM-adjacent untreated sites without baseline recession. However, ADM-adjacent untreated sites which had presented with recession at baseline but were not treated showed a significantly more apical shift of the gingival margin (almost two-fold). A significant increase in KTW was noted for all sites. Baseline KTW ≥2 mm was a significant predictor for the stability of the gingival margin at the ADM-treated, and the ADM-adjacent sites with baseline recession.
ADM-treated sites displayed recession relapse from 1 to 9 years. The untreated adjacent sites with a recession at baseline, showed a higher apical displacement of the gingival margin compared with the ADM-treated sites, and ADM-adjacent sites without a recession at baseline.
脱细胞真皮基质(ADM)治疗孤立性牙龈退缩的长期效果尚未得到评估。因此,本研究旨在观察随时间推移,ADM 冠状推进瓣的根覆盖效果,并将其与相邻未治疗部位进行比较。
12 名患者(共 20 名)在 9 年的随访中可用。通过混合模型回归分析,评估并比较了临床参数(退缩深度、平均根覆盖[RC]、角化组织宽度[KTW]和牙龈厚度)与 1 年结果以及 ADM 相邻未治疗部位(近中及远中)。
从 1 年到 9 年,ADM 治疗的孤立性退缩显示 RC 从 77%到 62%的复发(P<0.05)。ADM 相邻未治疗的无基线退缩的部位也出现了向根尖方向移动的类似模式。然而,基线有退缩但未治疗的 ADM 相邻未治疗部位的牙龈边缘向根尖方向移动明显更多(几乎两倍)。所有部位的 KTW 均显著增加。基线 KTW≥2mm 是 ADM 治疗和基线有退缩的 ADM 相邻部位牙龈边缘稳定性的显著预测因子。
ADM 治疗部位在 1 至 9 年期间显示出退缩复发。基线有退缩的未治疗相邻部位与 ADM 治疗部位和基线有退缩的 ADM 相邻部位相比,牙龈边缘的根尖位移更高。