Department of Stomatology II, University of the Basque Country (UPV/EHU), UPV/EHU. Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain.
Department of Nursing I, University of the Basque Country (UPV/EHU), Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain.
BMC Oral Health. 2021 Mar 22;21(1):145. doi: 10.1186/s12903-021-01494-3.
The primary objective of this systematic review and meta-analysis was to assess the evidence on complete root coverage (CRC) achieved by periodontal plastic techniques in the treatment of Miller class III/RT2 gingival recessions, comparing techniques developed along the twentieth century (pre-twenty-first) versus surgical approaches of the twenty-first century (21st).
An electronic bibliographic search was carried out in four databases up to December 2019, focusing on studies that reported CRC results in Miller class III or RT2 recessions treatment with at least a six-month follow-up. In addition, a random-effects models' meta-analysis was performed for the CRC, comparing pre-twenty-first versus twenty-first century techniques at 6 months, 12 months and more than 12 months.
Thirty-seven publications were included. A total of 933 gingival recessions were treated, 298 with pre-twenty-first century surgical techniques and 635 with techniques from the twenty-first century. CRC was achieved at 6 months on half of the recessions (pre-twenty-first: 57.60% vs. 21st: 51.11%), but decreased markedly for twenty-first century techniques at 12 months (pre-twenty-first: 63.82% vs. 21st: 32.87%). Thereafter, this difference was the other way around (> 12 months: pre-twenty-first: 5.26% vs. 21st: 19.65%). The meta-analysis showed a high heterogeneity, with no significant differences amongst the techniques.
Although CRC might be achievable by treating Miller class III or RT2 recessions with any of the described techniques, its long-term stability is not predictable. More randomized clinical trials with longer follow-ups and several visits, are needed. In addition, the patient's satisfaction should also be assessed.
本系统评价和荟萃分析的主要目的是评估牙周整形技术治疗 Miller 分类 III/RT2 牙龈退缩时获得完全根覆盖（CRC）的证据，比较 20 世纪（21 世纪前）开发的技术与 21 世纪的手术方法（21 世纪）。
我们在四个数据库中进行了电子文献检索，截至 2019 年 12 月，重点关注报告了 Miller 分类 III 或 RT2 退缩治疗中 CRC 结果的研究，这些研究至少有 6 个月的随访。此外，我们还对 CRC 进行了随机效应模型荟萃分析，比较了 21 世纪前与 21 世纪的技术在 6 个月、12 个月和 12 个月以上的差异。
共纳入 37 项研究。共有 933 个牙龈退缩接受了治疗，其中 298 个采用了 21 世纪前的手术技术，635 个采用了 21 世纪的技术。在一半的退缩中，6 个月时达到了 CRC（21 世纪前：57.60% vs. 21 世纪：51.11%），但在 12 个月时，21 世纪的技术明显下降（21 世纪前：63.82% vs. 21 世纪：32.87%）。此后，这种差异则相反（>12 个月：21 世纪前：5.26% vs. 21 世纪：19.65%）。荟萃分析显示存在高度异质性，各技术之间无显著差异。
尽管通过任何描述的技术治疗 Miller 分类 III 或 RT2 退缩都可能获得 CRC，但无法预测其长期稳定性。需要更多具有更长随访时间和多次就诊的随机临床试验，此外还应评估患者的满意度。
