Górski Bartłomiej, Szerszeń Marcin
Department of Periodontal and Oral Mucosa Diseases, Medical University of Warsaw, 02097 Warsaw, Poland.
Department of Prosthodontics, Medical University of Warsaw, 02097 Warsaw, Poland.
Gels. 2022 Jan 4;8(1):31. doi: 10.3390/gels8010031.
To improve treatment efficacy of gingival recessions (GR), chemical preparation of the exposed root surface was advocated. The aim of this study was to compare the additional influence of root biomodifications with 24% ethylenediaminetetraacetic acid (EDTA) alone or with enamel matrix derivative (EMD) on the 12 month outcomes of modified coronally advanced tunnel (MCAT) with subepithelial connective tissue graft in the treatment of multiple GR. Average root coverage (ARC), complete root coverage (CRC), reduction in GR, reduction in recession width (RW), gain in clinical attachment level (CAL), increase in gingival thickness (GT), increase in keratinized tissue width (KTW) and changes in root coverage esthetic score (RES) were evaluated. A total of 60 patients with 215 GR were enrolled. In 70, GR root surfaces were treated with EDTA + EMD, in other 72, with EDTA, while in the remaining 73 saline solution was applied. ARC was 94%, 89%, and 91% in the EDTA + EMD, the EDTA and the saline groups, respectively ( = 0.8871). Gains in clinical attachment level (CAL; 2.1 ± 1.1 mm) and RES values (9.6 ± 0.9) were significantly higher in the EDTA + EMD group, when compared with two other groups. The differences between other preoperative and postoperative parameters showed statistical significance only within but not between groups. MCAT outcomes may benefit from adjunctive use of EDTA + EMD regarding 12 month CAL gain and professionally assessed esthetics using RES following treatment of GR.
为提高牙龈退缩（GR）的治疗效果，人们提倡对暴露的牙根表面进行化学处理。本研究的目的是比较单独使用24%乙二胺四乙酸（EDTA）或联合釉基质衍生物（EMD）进行牙根生物改性对改良冠向推进隧道术（MCAT）联合上皮下结缔组织移植治疗多处GR的12个月疗效的额外影响。评估了平均牙根覆盖（ARC）、完全牙根覆盖（CRC）、GR减少量、退缩宽度（RW）减少量、临床附着水平（CAL）增加量、牙龈厚度（GT）增加量、角化组织宽度（KTW）增加量以及牙根覆盖美学评分（RES）的变化。共纳入60例患有215处GR的患者。其中70处GR的牙根表面用EDTA + EMD处理，另外72处用EDTA处理，其余73处应用生理盐水。EDTA + EMD组、EDTA组和生理盐水组的ARC分别为94%、89%和91%（ = 0.8871）。与其他两组相比，EDTA + EMD组的临床附着水平增加量（CAL；2.1±1.1 mm）和RES值（9.6±0.9）显著更高。其他术前和术后参数之间的差异仅在组内具有统计学意义，而组间无统计学意义。对于GR治疗后12个月的CAL增加量以及使用RES进行专业评估的美学效果，MCAT的疗效可能受益于EDTA + EMD的辅助使用。
