Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, 02097, Warsaw, Poland.
Department of Prosthodontics, Medical University of Warsaw, 02097, Warsaw, Poland.
Clin Oral Investig. 2023 May;27(5):2395-2406. doi: 10.1007/s00784-023-04887-6. Epub 2023 Feb 3.
The aim of this study was to investigate differences in clinical and esthetic outcomes in the treatment of multiple gingival recession types 1 and 2, using the modified coronally advanced tunnel technique (MCAT) combined with subepithelial connective tissue graft (SCTG), with or without cross-linked hyaluronic acid (HA).
A total of 24 patients with 266 multiple gingival recessions (GR) were enrolled in the study (133 recessions per group). MCAT was combined with SCTG and HA on the test side, while MCAT with SCTG was used on the control side. Clinical parameters were measured at baseline and 6 months post-operatively. Visual analogue scales (VAS) and questionnaires were used to assess patient-rated outcomes, and the root coverage esthetic score (RES) was used for professional esthetic evaluation.
No significant improvement in root coverage was observed as a result of adding HA. After 6 months, mean root coverage (MRC) was 85% for SCTG + HA group and 83% for SCTG group (p = 0.9819). Complete root coverage (CRC) was observed in 91% (test) and 93% (control) of the cases (p = 0.9001). Professional assessment of soft tissue texture (STT) using RES showed a significant difference (0.94 versus 0.69, p = 0.0219) in favor of the experimental group.
Both treatments were similarly effective in treating multiple GRs and led to comparable improvements in clinical parameters. However, application of HA improved the appearance of soft tissue texture.
Adjunctive application of HA in the MCAT + SCTG procedure may improve STT results.
本研究旨在通过改良的冠向推进隧道技术(MCAT)联合上皮下结缔组织移植(SCTG),并联合或不联合交联透明质酸(HA),比较治疗 1 型和 2 型多发性牙龈退缩的临床和美学效果差异。
共纳入 24 例患者(266 个多发牙龈退缩位点,每组 133 个)。实验组采用 MCAT 联合 SCTG 和 HA,对照组采用 MCAT 联合 SCTG。在基线和术后 6 个月时测量临床参数。采用视觉模拟评分(VAS)和问卷调查评估患者报告的结果,采用根覆盖美学评分(RES)进行专业美学评价。
添加 HA 并未显著提高根覆盖。术后 6 个月时,SCTG+HA 组的平均根覆盖(MRC)为 85%,SCTG 组为 83%(p=0.9819)。实验组和对照组的完全根覆盖(CRC)比例分别为 91%和 93%(p=0.9001)。使用 RES 评估软组织质地(STT)的专业评估显示,实验组的 STT 显著优于对照组(0.94 比 0.69,p=0.0219)。
两种治疗方法治疗多发性牙龈退缩均有效,且临床参数改善情况相当。然而,HA 的应用可改善软组织质地的外观。
MCAT+SCTG 术中联合应用 HA 可能会改善 STT 结果。