Mashaly Mohamed, Ghallab Noha A, Elbattawy Weam, Elarab Azza Ezz
Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt.
Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt.
Contemp Clin Dent. 2022 Jul-Sep;13(3):227-235. doi: 10.4103/ccd.ccd_763_20. Epub 2022 Sep 24.
The purpose of this randomized controlled clinical trial was to clinically assess soft tissue augmentation and compare patients' morbidity and root coverage outcomes of coronally advanced flap (CAF) with subepithelial connective tissue graft (SCTG) versus de-epithelialized free gingival graft (DFGG) in the management of Miller Class I and II gingival recession.
Twenty-eight patients with Miller's Class I or II gingival recession (GR) defects were randomly assigned into two equal parallel groups treated with either CAF + SCTG, harvested using single-line incision technique (control), or CAF + DFGG (test). Gingival thickness (GT), recession depth, recession width, percentage of root coverage, keratinized tissue width, pocket depth, and clinical attachment level were measured at baseline and 3 and 6 months postoperatively. Patient-reported outcomes were assessed postoperatively, including pain, stress, bleeding, and inability to chew. Patients' overall satisfaction and root coverage esthetic scores were recorded at 6 months.
Both groups demonstrated a statistically significant improvement in all clinical outcomes after 3 and 6 months compared to baseline. DFGG showed a statistically significant increase in GT after 6 months. No statistically significant difference was detected in other clinical outcomes between both groups at different time intervals. Both treatments achieved 92.9% complete root coverage. Patients treated with CAF + DFGG reported significantly higher stress and inability to chew scores after 2 weeks than those treated with SCTG. There were no significant differences in patient satisfaction between both groups.
CAF + SCTG and CAF + DFGG were both effective and can be applied safely in treating Miller Class I and II GRs.
本随机对照临床试验旨在对软组织增量进行临床评估，并比较冠向推进瓣（CAF）联合上皮下结缔组织移植（SCTG）与去上皮游离龈移植（DFGG）在治疗米勒I类和II类牙龈退缩时患者的发病率及牙根覆盖效果。
28例患有米勒I类或II类牙龈退缩（GR）缺损的患者被随机分为两个相等的平行组，分别接受CAF + SCTG（采用单线切口技术采集，为对照组）或CAF + DFGG（试验组）治疗。在基线时以及术后3个月和6个月测量牙龈厚度（GT）、退缩深度、退缩宽度、牙根覆盖百分比、角化组织宽度、袋深和临床附着水平。术后评估患者报告的结果，包括疼痛、压力、出血和咀嚼困难。在6个月时记录患者的总体满意度和牙根覆盖美学评分。
与基线相比，两组在术后3个月和6个月时所有临床指标均有统计学意义的改善。DFGG在术后6个月时GT有统计学意义的增加。在不同时间间隔，两组之间的其他临床指标未检测到统计学意义的差异。两种治疗方法均实现了92.9%的完全牙根覆盖。CAF + DFGG治疗的患者在术后2周报告的压力和咀嚼困难评分显著高于SCTG治疗的患者。两组患者满意度无显著差异。
CAF + SCTG和CAF + DFGG均有效且可安全应用于治疗米勒I类和II类GR。
