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采用袋形和隧道技术比较富血小板纤维蛋白与结缔组织移植治疗牙龈退缩的疗效:一项随机临床研究

Comparative Evaluation of Platelet-Rich Fibrin versus Connective Tissue Grafting in Treatment of Gingival Recession Using Pouch and Tunnel Technique: A Randomized Clinical Study.

作者信息

Chandra Vatsala, Bains Vivek Kumar, Jhingran Rajesh, Srivastava Ruchi, Madan Rohit

机构信息

Consultant Periodontist & Laser Specialist, Clove Dental Clinics, New Delhi, India.

Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India.

出版信息

Contemp Clin Dent. 2022 Jul-Sep;13(3):217-226. doi: 10.4103/ccd.ccd_749_20. Epub 2022 Sep 24.

Abstract

AIMS

The aim of the study was to compare the clinical efficacy of platelet-rich fibrin (PRF) and connective tissue grafting in the treatment of gingival recession (GR) using pouch and tunnel (P and T) technique.

MATERIALS AND METHODS

A total of 40 Class I or Class II GR defects in 17 patients were randomized treated with P and T with PRF (Group I, = 20) and P and T with CTG (Group II, = 20). The parameters measured were plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), horizontal gingival recession (HGR), vertical gingival recession (VGR), width of attached gingiva (WAG), width of keratinised gingiva (WKG), gingival thickness-mid buccal (GTMB), and gingival thickness interdental papilla (GTIP). Postsurgical discomfort level (PSDL), hypersensitivity score (HS), and patient esthetic score (PES) were recorded using visual analog scale (VAS). The PI, GI, PPD, CAL, HGR, VGR, WAG, WKG, GTMB, and GTIP were assessed at pretreatment (baseline) and 1-, 3-, and 6-month posttreatment. The PSDL, HS, and PES were assessed at baseline, day 10, 1, 3, and 6-month posttreatment.

RESULTS

P and T with PRF and CTG resulted in root coverage of 73.75% ± 7.80% and 70.83% ±8.26%, respectively. Patient response and acceptance for the surgical treatment modality showed less discomfort and better esthetics in Group I as compared to Group II.

CONCLUSIONS

PRF treated sites were comparable to the gold standard CTG with better patient acceptance and a lesser invasive approach in terms of graft procurement.

摘要

目的

本研究旨在比较富血小板纤维蛋白(PRF)和结缔组织移植术采用袋形和隧道形(P和T)技术治疗牙龈退缩(GR)的临床疗效。

材料与方法

17例患者共40处I类或II类GR缺损,随机分为PRF组(I组,n = 20)和结缔组织移植术组(II组,n = 20),分别采用P和T技术联合PRF及P和T技术联合结缔组织移植术(CTG)治疗。测量的参数包括菌斑指数(PI)、牙龈指数(GI)、探诊深度(PPD)、临床附着水平(CAL)、水平向牙龈退缩(HGR)、垂直向牙龈退缩(VGR)、附着龈宽度(WAG)、角化龈宽度(WKG)、颊侧中部牙龈厚度(GTMB)以及牙间乳头牙龈厚度(GTIP)。采用视觉模拟量表(VAS)记录术后不适程度(PSDL)、过敏评分(HS)和患者美学评分(PES)。在治疗前(基线)以及治疗后1、3和6个月评估PI、GI、PPD、CAL、HGR、VGR、WAG、WKG、GTMB和GTIP。在基线、术后第10天、1、3和6个月评估PSDL、HS和PES。

结果

PRF组和CTG组采用P和T技术治疗后牙根覆盖率分别为73.75%±7.80%和70.83%±8.26%。与II组相比,I组患者对手术治疗方式的反应和接受度显示不适更少,美学效果更好。

结论

PRF治疗部位与金标准CTG相当,患者接受度更高,且在移植物获取方面侵入性较小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3592/9533392/b42b9abbf3fc/CCD-13-217-g001.jpg

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