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富含生长因子的血浆联合隧道技术治疗牙龈退缩的疗效:一项临床试验

Efficacy of Application of Plasma Rich in Growth Factors Along with the Tunnel Technique for Treatment of Gingival Recession: a Clinical Trial.

作者信息

Ahrari Fatemeh, Keshavarzi Farshad, Bijani Ali, Jenabian Niloofar

机构信息

Student Research Committee, Dept. of Periodontics, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran.

Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

出版信息

J Dent (Shiraz). 2020 Dec;21(4):275-283. doi: 10.30476/DENTJODS.2020.83590.1052.

DOI:10.30476/DENTJODS.2020.83590.1052
PMID:33344677
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7737924/
Abstract

STATEMENT OF THE PROBLEM

The tunnel technique has shown promising results in treatment of gingival recession. Plasma rich in growth factors (PRGF) is considered effective for soft tissue regeneration since it is a rich source of growth factors.

PURPOSE

This clinical trial aimed to assess the efficacy of PRGF along with the tunnel technique and connective tissue graft for treatment of gingival recession.

MATERIALS AND METHOD

In this controlled clinical trial, 20 areas around anterior and posterior teeth in 3 patients with gingival recession were bilaterally selected. The tunnel technique was used with and without PRGF in the test and control groups, respectively (10 areas in each group). The keratinized gingival width (KGW), clinical attachment level (CAL), clinical probing depth (PD), cementoenamel junction (CEJ) to mucogingival junction (MGJ) distance, and the esthetic visual analog scale (EVAS) score were evaluated preoperatively and at 6 weeks and 3 months, postoperatively. The gingival recession width (RW) and vertical recession depth (VRD) were assessed preoperatively and at 2 weeks and 3 months, postoperatively. The pain visual analog scale (PVAS) score was measured at 1, 3 and 7 days, post-treatment and the healing index (HI) was measured at 1, 3 and 7 days and 1 month, postoperatively. The root coverage percentage was assessed during 3 months. Paired t-test and repeated measures ANOVA were used for statistical analyses. Value< 0.05 was considered statistically significant.

RESULTS

Significant improvements were noted in all tested parameters in both groups (< 0.05). The mean root coverage percentage after 6 months was 88.68%±20.69% and 78.77%±24.94% in the test and control groups, respectively. None of the tested parameters were significantly different between two groups (> 0.05).

CONCLUSION

Treatment of gingival recession with the tunnel technique can yield favorable clinical outcome, irrespective of the employment of PRGF.

摘要

问题陈述

隧道技术在牙龈退缩治疗中已显示出有前景的结果。富含生长因子的血浆(PRGF)被认为对软组织再生有效,因为它是生长因子的丰富来源。

目的

本临床试验旨在评估PRGF联合隧道技术和结缔组织移植治疗牙龈退缩的疗效。

材料与方法

在这项对照临床试验中,双侧选择了3例牙龈退缩患者的前牙和后牙周围的20个区域。试验组和对照组分别使用有PRGF和无PRGF的隧道技术(每组10个区域)。术前以及术后6周和3个月评估角化龈宽度(KGW)、临床附着水平(CAL)、临床探诊深度(PD)、牙骨质釉质界(CEJ)至膜龈联合(MGJ)的距离以及美学视觉模拟量表(EVAS)评分。术前以及术后2周和3个月评估牙龈退缩宽度(RW)和垂直退缩深度(VRD)。治疗后1、3和7天测量疼痛视觉模拟量表(PVAS)评分,术后1、3和7天以及1个月测量愈合指数(HI)。在3个月期间评估牙根覆盖百分比。采用配对t检验和重复测量方差分析进行统计分析。P值<0.05被认为具有统计学意义。

结果

两组所有测试参数均有显著改善(P<0.05)。6个月后试验组和对照组的平均牙根覆盖百分比分别为88.68%±20.69%和78.77%±24.94%。两组之间的所有测试参数均无显著差异(P>0.05)。

结论

无论是否使用PRGF,采用隧道技术治疗牙龈退缩均可产生良好的临床效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/494806dae47e/JDS-21-275-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/8d1ce1746b4f/JDS-21-275-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/5f71db1757d5/JDS-21-275-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/60f94e7192db/JDS-21-275-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/c1d0480c84d5/JDS-21-275-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/494806dae47e/JDS-21-275-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/8d1ce1746b4f/JDS-21-275-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/5f71db1757d5/JDS-21-275-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/60f94e7192db/JDS-21-275-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/c1d0480c84d5/JDS-21-275-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d096/7737924/494806dae47e/JDS-21-275-g005.jpg

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本文引用的文献

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Coverage of Multiple Mandibular Gingival Recessions Using Tunnel Technique with Connective Tissue Graft: A Prospective Case Series.采用带结缔组织移植的隧道技术覆盖多个下颌牙龈退缩:一项前瞻性病例系列研究
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Subepithelial connective tissue graft with and without the use of plasma rich in growth factors for treating root exposure.
使用和不使用富含生长因子的血浆的上皮下结缔组织移植治疗牙根暴露。
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Plasma rich in growth factors promote gingival tissue regeneration by stimulating fibroblast proliferation and migration and by blocking transforming growth factor-β1-induced myodifferentiation.富含生长因子的血浆通过刺激成纤维细胞增殖和迁移,并阻断转化生长因子-β1 诱导的成肌分化,促进牙龈组织再生。
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