Goyal Lata, Chawla Kirti
Department of Dentistry (Periodontology), All India Institute of Medical Sciences, Bathinda, India.
Department of Periodontics, Jamia Millia Islamia, New Delhi, India.
J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):237-244. doi: 10.1016/j.jobcr.2021.02.004. Epub 2021 Feb 12.
To address the clinical question whether microsurgery hold an advantage in terms of clinical and patient oriented outcome over conventional macrosurgical procedures in the treatment of gingival recession.
A Literature search on MEDLINE, SCOPUS, EMBASE (Excerpta Medica Database) via Ovid and Cochrane library was conducted in order to investigate clinical studies on efficacy of microsurgery in the treatment of localized or multiple gingival recession as compared to conventional macrosurgical procedures. Publications before May 2020 and grey literature was searched without any language restrictions. Primary outcome considered was change in recession depth and mean root coverage. Whereas, change in clinical attachment level, Change in keratinized tissue, patient oriented outcome like esthetics, pain and discomfort were the secondary outcome. Based on inclusion criteria ten studies were included in systematic review. Data was extracted and analyzed.
All the included studies showed improvement in the mean percentage of root coverage or mean root coverage (primary outcome) when microsurgical approach was used. Predictability of complete root coverage is better with microsurgical instrumentation but results are not statistically significant. As far as patient centered outcome is concerned, there is no evidence for recommendation of microsurgery.
探讨在治疗牙龈退缩方面，与传统宏观手术相比，显微手术在临床及以患者为导向的治疗结果上是否具有优势。
通过Ovid对MEDLINE、SCOPUS、EMBASE（医学文摘数据库）以及Cochrane图书馆进行文献检索，以调查与传统宏观手术相比，显微手术治疗局限性或多发性牙龈退缩疗效的临床研究。检索了2020年5月之前的出版物及灰色文献，无任何语言限制。主要观察指标为退缩深度的变化和平均牙根覆盖情况。而临床附着水平的变化、角化组织的变化、以患者为导向的结果如美观、疼痛和不适则为次要观察指标。根据纳入标准，十项研究被纳入系统评价。对数据进行提取和分析。
所有纳入研究均表明，采用显微手术方法时，平均牙根覆盖百分比或平均牙根覆盖（主要观察指标）有所改善。使用显微手术器械时，完全牙根覆盖的可预测性更好，但结果无统计学意义。就以患者为中心的结果而言，没有证据支持推荐显微手术。
