Department of Periodontics and Implantology, Vishnu Dental College, Vishnupur, Bhimavaram, 534202, West Godavari, Andhra Pradesh, India.
Clin Oral Investig. 2023 Mar;27(3):1101-1111. doi: 10.1007/s00784-022-04700-w. Epub 2022 Sep 4.
Root coverage (RC) is an integral part in management of gingival recessions. Unlike isolated recessions, treating multiple recessions is the most challenging scenario especially in smokers who have reported reduced RC in terms of quantity and stability. Modified coronally advanced tunnel (MCAT) technique due to its improved vascularity along with use of porcine-derived collagen matrix (PDCM) (Mucograft™) with its bilayered dense collagen matrix may be a predictable alternative to conventional gold standard subepithelial connective tissue graft (SCTG). The purpose of this study was to compare the results of RC achieved using PDCM and SCTG with the MCAT approach in the treatment of multiple gingival recessions in smokers.
This is a prospective randomized controlled clinical study registered under clinical trial registry (CTRI no. CTRI/2020/03/024238) including 28 patients with 64 recession defects. Smokers (≥ 10 cigarettes/day for ≥ 5 years) fulfilling the inclusion criteria were randomized into the SCTG and PDCM groups which were treated with SCTG using MCAT and PDCM using MCAT technique, respectively. Recession depth (RD), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized gingiva (TKG), and %RC were assessed at baseline, 3, and 6 months. Complete RC (CRC) at 3 and 6 months, RC aesthetic scores (RCES) at 6 months.
Both groups showed significant improvement in all clinical parameters. Intergroup comparison of root coverage parameters in smokers showed better performance of the PDCM group in terms of RD, %RC, TKG, WKT, CRC (45.06%), and RCES (p < 0.001) compared to the SCTG group. Time taken for surgical procedure and visual analog pain scores were significantly lesser in the PDCM group.
PDCM showed good predictable results in terms of all RC parameters compared to SCTG and thus may be used as a predictable alternative to SCTG for RC in smokers.
PDCM can be used as a potential alternative to gold standard subepithelial connective tissue graft in smokers with better patient compliance.
根面覆盖（RC）是治疗牙龈退缩的重要组成部分。与孤立性退缩不同，治疗多个退缩是最具挑战性的情况，尤其是在报告 RC 数量和稳定性降低的吸烟者中。由于改良的冠向推进隧道（MCAT）技术具有改善的血管生成，同时使用猪源性胶原基质（PDCM）（Mucograft™）双层致密胶原基质，可能是传统上皮下结缔组织移植物（SCTG）的一种可预测的替代方法。本研究的目的是比较使用 PDCM 和 SCTG 与 MCAT 方法治疗吸烟者多个牙龈退缩的 RC 结果。
这是一项前瞻性随机对照临床试验，在临床试验注册处（CTRI 编号：CTRI/2020/03/024238）注册，包括 28 名 64 个退缩缺陷患者。符合纳入标准的吸烟者（每天≥10 支香烟，≥5 年）被随机分为 SCTG 组和 PDCM 组，分别使用 MCAT 技术进行 SCTG 和 PDCM 治疗。在基线、3 个月和 6 个月时评估退缩深度（RD）、退缩宽度（RW）、角化组织宽度（WKT）、角化龈厚度（TKG）和%RC。3 个月和 6 个月时评估完全 RC（CRC），6 个月时评估 RC 美学评分（RCES）。
两组在所有临床参数上均有显著改善。吸烟者的根覆盖参数的组间比较显示，PDCM 组在 RD、%RC、TKG、WKT、CRC（45.06%）和 RCES 方面表现优于 SCTG 组（p<0.001）。PDCM 组手术时间和视觉模拟疼痛评分明显较低。
PDCM 在所有 RC 参数方面均显示出良好的可预测结果，与 SCTG 相比，可作为 RC 在吸烟者中的一种可预测替代方法。
PDCM 可以作为吸烟者中黄金标准上皮下结缔组织移植物的潜在替代方法，具有更好的患者依从性。
