Toledano-Osorio Manuel, Muñoz-Soto Esther, Toledano Manuel, Vallecillo-Rivas Marta, Vallecillo Cristina, Ramos-García Pablo, Osorio Raquel
Faculty of Dentistry, Colegio Máximo de Cartuja s/n, University of Granada, 18071 Granada, Spain.
Polymers (Basel). 2022 Apr 2;14(7):1453. doi: 10.3390/polym14071453.
Gingival recessions are a prevalent oral mucosa alteration. To solve this pathology, palatal mucosa or polymeric soft tissue substitutes are used when performing coronal advanced flap (CAF) or tunnel (TUN) surgical techniques. To evaluate which is the most successful approach, a literature review and meta-analysis were conducted. For the electronic search the National Library of Medicine, the Cochrane Oral Health Group Trials Register, EMBASE and WOS were used. Pooled data for the percentage of root coverage was collected and weighted means were calculated. Heterogeneity was determined using the Higgins (I) statistic and a random-effects model was applied. Thirteen studies were included in the systematic review (12 randomized and 1 controlled clinical trials) in which both techniques (394 patients) were compared with a follow-up of 4 to 12 months. Galbraith and Baujat plots were used to control for the presence of potential outliers. After performing the meta-analysis (11 studies), the mean root coverage was similar when using the TUN or CAF techniques ( = 0.49). The only differences between the two were found for single recessions, where CAF offered a higher percentage of root coverage (mean difference = 4.98%; = 0.006). There were no differences when applying an autograft or a polymeric substitute with either of the two tested surgical techniques ( = 0.445).
牙龈退缩是一种常见的口腔黏膜改变。为了解决这一病理问题，在进行冠向推进瓣（CAF）或隧道（TUN）手术技术时，会使用腭黏膜或聚合物软组织替代物。为了评估哪种方法最成功，进行了一项文献综述和荟萃分析。电子检索使用了美国国立医学图书馆、Cochrane口腔健康组试验注册库、EMBASE和WOS。收集了牙根覆盖百分比的汇总数据并计算加权均值。使用希金斯（I）统计量确定异质性，并应用随机效应模型。系统评价纳入了13项研究（12项随机对照试验和1项对照临床试验），对两种技术（394例患者）进行了比较，随访时间为4至12个月。使用加尔布雷思图和鲍亚特图来控制潜在异常值的存在。进行荟萃分析（11项研究）后，使用TUN或CAF技术时的平均牙根覆盖相似（ = 0.49）。两者之间的唯一差异在于单个退缩情况，CAF的牙根覆盖百分比更高（平均差异 = 4.98%； = 0.006）。在两种测试手术技术中应用自体移植物或聚合物替代物时没有差异（ = 0.445）。
