Discipline of Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
Discipline of Pathology and Oral Pathology, Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
J Clin Periodontol. 2021 Mar;48(3):431-440. doi: 10.1111/jcpe.13413. Epub 2021 Jan 26.
This prospective cohort study evaluated late complications (LC) on recipient sites comparing two types of connective tissue grafts (CTG).
Participants (n: 60) were treated with coronally advanced flap (CAF) plus CTG harvested by de-epithelialized technique (DE) (n:31) or two-parallel incision (PI) (n:29). Areas were evaluated to identify white discharge associated or not with gingival cul-de-sac. Patients were ordered in groups with (DE+and PI+) or without (DE- and PI-) LC. Biopsies for histopathological analysis in LC areas were proposed.
Six cases exhibited LC, 5 in DE graft (DE+) and 1 in PI graft (PI+) group; 2 were diagnosed at 3 months postoperatively, 3 at 6 months and one at 12 months. The relative risk for LC was 1.7 times greater for DE graft (p: 0.01; CI: 1.10 to 2.72; RR>1). Differences were not observed for clinical outcomes after both types of CTGs (p > 0.05). Biopsies showed deep invagination of the epithelial lining suggesting cyst-like area/ cavity with keratin content and consolidated in fibrous connective tissue. After 24 months biopsied areas presented no recurrence of LC, in non-biopsied patients the clinical condition remained unchanged.
Considering the limitations of this study, LC on recipient sites demonstrated no statistical difference between two types of CTG.
本前瞻性队列研究通过比较两种结缔组织移植物(CTG),评估了受植区的迟发性并发症(LC)。
研究纳入了(n=60)名接受冠向推进瓣(CAF)联合 CTG 治疗的患者,CTG 是通过去上皮化技术(DE)(n=31)或双平行切口(PI)(n=29)获取的。对这些区域进行评估,以确定是否存在与牙龈袋相关的白色分泌物。将患者分为有(DE+和 PI+)或无(DE-和 PI-)LC 的两组。建议在 LC 区域进行组织病理学分析活检。
6 例患者出现 LC,其中 5 例发生在 DE 移植物(DE+),1 例发生在 PI 移植物(PI+);2 例于术后 3 个月,3 例于术后 6 个月,1 例于术后 12 个月诊断出 LC。DE 移植物发生 LC 的相对风险是 PI 移植物的 1.7 倍(p:0.01;CI:1.10 至 2.72;RR>1)。两种 CTG 后临床结果无差异(p>0.05)。活检显示上皮衬里的深内陷,提示存在类似囊样区域/腔隙,内含角蛋白并被纤维结缔组织固定。在 24 个月的活检区域中,未发现 LC 复发,在未活检的患者中,临床状况保持不变。
考虑到本研究的局限性,两种 CTG 在受植区的 LC 无统计学差异。