Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz-Cooperativa de Ensino Superior, Caparica, Almada, Portugal.
Graduate Dentistry Program, School of Dentistry, Ibirapuera University, São Paulo, Brazil.
J Periodontol. 2022 Sep;93(9):1336-1352. doi: 10.1002/JPER.22-0167. Epub 2022 May 12.
The aim of this systematic review and network meta-analysis (NMA) was to assess the efficacy of a bilaminar root coverage technique consisting of the combination of an autogenous subepithelial connective tissue graft (SCTG) and a coronally advanced flap (CAF) compared with the five most indicated alternative approaches for the treatment of single gingival recession defects (GRD).
The protocol of this PRISMA 2020-compliant systematic review was registered in PROSPERO (CRD42020221362). Three electronic databases were searched up to September 30, 2021 to identify randomized controlled trials that involved the treatment of single GRD without interproximal tissue loss via root coverage procedures. A frequentist NMA was conducted for complete root coverage (CRC), mean root coverage (MRC), and keratinized tissue width (KTW) changes.
A total of 38 studies reporting on 830 patients and 1,265 GRD were included. SCTG + CAF was ranked as the most efficient treatment approach for MRC, CRC, and KTW gain at 6 and 12 months after surgery, except for MRC at the 12-month follow-up where enamel matrix derivative plus CAF exhibited superior results.
SCTG + CAF can be considered the gold standard for the treatment of single GRD.
本系统评价和网络荟萃分析（NMA）的目的是评估双层根覆盖技术的疗效，该技术由自体黏膜下结缔组织移植（SCTG）和冠向推进瓣（CAF）联合组成，用于治疗单个牙龈退缩缺陷（GRD），与 5 种最常用的替代方法相比。
本 PRISMA 2020 符合协议的系统评价方案已在 PROSPERO（CRD42020221362）中注册。截至 2021 年 9 月 30 日，我们检索了 3 个电子数据库，以确定涉及通过根覆盖程序治疗无邻间组织丧失的单个 GRD 的随机对照试验。我们进行了频率论 NMA，以评估完全根覆盖（CRC）、平均根覆盖（MRC）和角化组织宽度（KTW）的变化。
共有 38 项研究报告了 830 名患者和 1265 个 GRD，纳入了本研究。SCTG + CAF 在术后 6 个月和 12 个月时的 MRC、CRC 和 KTW 增加方面被评为最有效的治疗方法，除了在 12 个月的随访中，牙骨质衍生蛋白加 CAF 显示出更好的结果外，MRC 在 12 个月的随访中。
SCTG + CAF 可被视为治疗单个 GRD 的金标准。
