Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor-Boston, Michigan, USA.
J Clin Periodontol. 2022 Jul;49(7):672-683. doi: 10.1111/jcpe.13641. Epub 2022 May 13.
To assess the prognostic value of soft tissue phenotype modification following root coverage procedures for predicting the long-term (10-year) behaviour of the gingival margin.
Participants from six randomized clinical trials on root coverage procedures at the University of Michigan were re-invited for a longitudinal evaluation. Clinical measurements were obtained by two calibrated examiners. A data-driven approach to model selection with Akaike information criterion (AIC) was carried out via multilevel regression analyses and partial regression plotting for changes in the level of the gingival margin over time and interactions with the early (6-month) results of soft tissue phenotypic modification.
One-hundred and fifty-seven treated sites in 83 patients were re-assessed at the long-term recall. AIC-driven model selection and regression analyses demonstrated that 6-month keratinized tissue width (KTW) and gingival thickness (GT) influenced the trajectory of the gingival margin similarly in a concave manner; however, GT was the driving determinant that predicted significantly less relapse in the treatments, with stability of the treated gingival margin obtained beyond values of 1.46 mm.
Among a compliant patient cohort, irrespective of the rendered therapy, the presence of at least 1.5 mm KTW and 1.46 mm GT was correlated with the long-term stability of the gingival margin.
评估根面覆盖术后软组织表型改变对预测牙龈边缘长期(10 年)行为的预后价值。
密歇根大学 6 项根面覆盖术随机临床试验的参与者被重新邀请进行纵向评估。临床测量由两名经过校准的检查者进行。通过多层次回归分析和偏回归绘图,采用基于 Akaike 信息准则(AIC)的数据驱动方法对模型进行选择,以研究牙龈边缘水平随时间的变化以及与软组织表型改变早期(6 个月)结果的相互作用。
83 名患者的 157 个治疗部位在长期随访中重新评估。AIC 驱动的模型选择和回归分析表明,6 个月时的角化组织宽度(KTW)和牙龈厚度(GT)以类似的凹形方式影响牙龈边缘的轨迹;然而,GT 是预测治疗中复发率显著降低的驱动因素,在治疗获得超过 1.46mm 的稳定的牙龈边缘值后,稳定得以维持。
在一个依从性好的患者队列中,无论采用何种治疗方法,至少存在 1.5mm 的 KTW 和 1.46mm 的 GT 与牙龈边缘的长期稳定性相关。