Pitale Unnati, Pal Pritish Chandra, Boyapati Ramanarayana, Bali Ashish, Varma Manish, Khetarpal Shaleen
Department of Periodontics, Modern Dental College & Research Centre, Indore, India.
Department of Periodontics, Pacific Dental College and Hospital, Udaipur, India.
J Korean Assoc Oral Maxillofac Surg. 2021 Dec 31;47(6):438-444. doi: 10.5125/jkaoms.2021.47.6.438.
Loss of the interdental papilla is multi-factorial and creates a multitude of problems. Autogenous connective tissue/biomaterial-based regeneration has been attempted for decades to reconstitute the black space created due to the loss of papilla. The aim of this present study was to regenerate papillary recession defects using an amnion-chorion membrane (ACM) allograft and to evaluate the clinical outcome up to six months postoperatively.
Twenty patients with 25 Nordland and Tarnow's Class I/II interdental papillary recession defects were treated with ACM and coronal advancement of the gingivo-papillary unit via a semilunar incision on the labial aspect followed by a sulcular incision in the area of interest. A photographic image analysis was carried out using the GNU Image Manipulation software program from the baseline to three and six months postoperatively. The black triangle height (BTH) and the black triangle width (BTW) were calculated using the pixel size and were then converted into millimeters. The mean and standard deviation values were determined at baseline and then again at three and six months postoperatively. The probability values ( <0.05 and P≤0.01) were considered statistically significant and highly significant, respectively. An analysis of variance and post hoc Bonferroni test were carried out to compare the mean values.
Our evaluation of the BTH and BTW showed a statistically and highly significant difference from the baseline until both three and six months postoperatively (=0.01). A post hoc Bonferroni test disclosed a statistically significant variance from the baseline until three and six months postoperatively ( <0.05) and a non-significant difference from three to six months after the procedure (P≥0.05).
An ACM allograft in conjunction with a coronally advanced flap could be a suitable minimally invasive alternative for papillary regeneration.
牙间乳头丧失是多因素导致的，会引发诸多问题。几十年来，人们一直尝试通过自体结缔组织/生物材料进行再生，以修复因乳头丧失而产生的黑色间隙。本研究的目的是使用羊膜 - 绒毛膜（ACM）同种异体移植物再生乳头退缩缺损，并评估术后六个月的临床效果。
20例患有25个Nordland和Tarnow I/II类牙间乳头退缩缺损的患者接受了ACM治疗，并通过唇侧半月形切口，随后在感兴趣区域进行龈沟切口，对龈乳头单位进行冠向推进。使用GNU图像处理软件程序从基线到术后三个月和六个月进行摄影图像分析。使用像素大小计算黑色三角形高度（BTH）和黑色三角形宽度（BTW），然后将其转换为毫米。在基线时确定平均值和标准差，然后在术后三个月和六个月再次确定。概率值（<0.05和P≤0.01）分别被认为具有统计学意义和高度统计学意义。进行方差分析和事后Bonferroni检验以比较平均值。
我们对BTH和BTW的评估显示，从基线到术后三个月和六个月均存在统计学上的高度显著差异（P = 0.01）。事后Bonferroni检验显示，从基线到术后三个月和六个月存在统计学上的显著差异（P <0.05），而术后三个月到六个月之间无显著差异（P≥0.05）。
ACM同种异体移植物联合冠向推进瓣可能是乳头再生的一种合适的微创替代方法。
