Quintessence Int. 2021;52(1):32-44. doi: 10.3290/j.qi.a45171.
Objective: To evaluate the long-term clinical results after treatment of multiple adjacent recession type (RT) I and II gingival recessions treated with the modified coronally advanced tunnel (MCAT) in conjunction with a porcine acellular dermal matrix (PADM).
Method and materials: Nine periodontally healthy nonsmoking patients (seven women, 37.5 ± 7.36 years old) with a total of 41 adjacent RT I (n = 23) and RT II (n = 18) gingival recessions exhibiting a minimum depth of 2 mm were treated by means of MCAT+PADM. Recession depth and width, width of attached and keratinized tissue, probing depths, and clinical attachment level were measured at baseline and at 1 and 4 years postsurgically. The primary outcome variable was complete root coverage (ie 100% root coverage), while secondary outcomes were mean root coverage and increase in keratinized tissue and attached gingiva widths.
Results: At 1 and 4 years, statistically highly significant (P < .001) root coverage was obtained in all nine patients compared to baseline. Mean root coverage decreased in these nine patients from 72.05 ± 30.18% at 1 year to 56.79 ± 27.53% at 4 years. Complete root coverage was obtained in 18 gingival recessions at 1 year (baseline RT: 12 RT I, 6 RT II) and in seven gingival recessions (5 RT I, 2 RT II) at 4 years. Most root coverage occurred in the first year postsurgically, showing a statistically significant decrease between the first and fourth year (P = .003). Mean width of attached gingiva increased statistically significantly (P < .05) from 2.85 ± 1.08 mm to 3.14 ± 1.08 mm at 1 year with a statistically significant decrease at 4 years. At 1 year, 78.05% of gingival recessions showed a root coverage > 50%, and 68.29% still exhibited a root coverage > 50% at 4 years.
Conclusion: The use of MCAT+PADM represents a valuable treatment option for multiple adjacent maxillary and mandibular RT I and II gingival recessions on a long-term basis.
评估改良冠向推进隧道（MCAT）联合猪脱细胞真皮基质（PADM）治疗多发性邻面退缩型（RT）I 和 II 牙龈退缩的长期临床效果。
方法和材料：9 名牙周健康的非吸烟患者（7 名女性，37.5 ± 7.36 岁），共 41 个邻面 RT I（n = 23）和 RT II（n = 18）牙龈退缩，至少有 2mm 的深度。通过 MCAT+PADM 治疗。在基线、术后 1 年和 4 年时测量退缩深度和宽度、附着和角化组织宽度、探诊深度和临床附着水平。主要观察变量为完全根覆盖（即 100%根覆盖），次要观察变量为平均根覆盖和角化组织及附着龈宽度的增加。
结果：9 名患者在 1 年和 4 年时与基线相比，均获得了统计学上显著（P <.001）的根覆盖。这些患者的平均根覆盖从第 1 年的 72.05 ± 30.18%下降到第 4 年的 56.79 ± 27.53%。9 名患者中有 18 个牙龈退缩在第 1 年（基线 RT：12 个 RT I，6 个 RT II）和 7 个牙龈退缩在第 4 年（5 个 RT I，2 个 RT II）获得了完全根覆盖。大多数根覆盖发生在术后第 1 年，第 1 年和第 4 年之间的差异有统计学意义（P =.003）。附着龈的平均宽度在第 1 年显著增加（P <.05），从 2.85 ± 1.08mm 增加到 3.14 ± 1.08mm，第 4 年有统计学意义的下降。第 1 年，78.05%的牙龈退缩显示根覆盖>50%，第 4 年仍有 68.29%的牙龈退缩显示根覆盖>50%。
结论：长期使用 MCAT+PADM 是治疗多发性上颌和下颌 RT I 和 II 牙龈退缩的一种有价值的治疗选择。
