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一项比较MVISTA与绒毛膜或结缔组织移植物治疗多处牙龈退缩临床效果的随机对照双盲试验。

A split-mouth randomised controlled trial comparing the clinical effects of MVISTA with chorion membrane or connective tissue graft in multiple gingival recessions.

作者信息

Pereira Marisca Austin, Medikeri Raghavendra S, Waingade Manjushri

机构信息

Department of Periodontology, Sinhgad Dental College and Hospital, Pune, India.

Department of Oral Medicine & Radiology, Sinhgad Dental College and Hospital, Pune, India.

出版信息

Saudi Dent J. 2023 Feb;35(2):178-184. doi: 10.1016/j.sdentj.2022.12.011. Epub 2023 Jan 2.

Abstract

OBJECTIVES

Modified form of VISTA (MVISTA), a novel surgical procedure, aims at comprehensive root coverage that maintains the inner continuity of the periosteum and papilla. This technique incorporates any regenerative graft material within the tunnel. The objective of study is to compare the MVISTA for treating multiple adjacent gingival recessions and chorion membranes or grafts of connective tissues.

MATERIALS AND METHODS

This is a split-mouth type randomized trial. In this trial total of 18 patients were considered. The patients in this trial had multiple adjacent, gingival recessions of Miller's Classes I/II, and they were randomized to either the MVISTA with chorion membrane (test) or connective tissue graft (CTG) (control) group. A baseline and one year after surgery were considered for recording to mean root coverage (MRC), complete root coverage (CRC), and clinical periodontal parameters. An intragroup comparison was made.

RESULTS

The intragroup comparison of recession depth baseline and 12 months after-surgery record found a significant difference between the two groups (P = 0.00). In the postoperative condition, the depth of recession reduction was higher in the test group than in the control group. However, from a statistical perspective, the difference was insignificant (P > 0.05). At the end of the year, it was found that the width of the keratinized tissue had increased significantly (P < 0.05). The MRC in the test group was significantly higher (91.33 %±8.17 %) than that in the control group (89.46 %±11.22 %) (P > 000). At the end of 1 year, the test group showed 66.67 % CRC compared to 44.44 % in the control group. The gingival phenotype displayed statistically significant improvement in the test group (p = 0.004). PD and CAL showed statistically nonsignificant outcomes (P > 0.05).

CONCLUSIONS

As far as multiple adjacent gingival recession treatment is concerned, MVISTA with chorion membrane treatment enhanced the gingival phenotype, restored complete root coverage (66.6%), and increased the width of keratinized tissue. CTG and CM demonstrated good root coverage results; the latter might be used as a substitute graft to treat multiple recessions.

摘要

目的

改良型VISTA(MVISTA)是一种新型手术方法,旨在实现全面的牙根覆盖,同时保持骨膜和龈乳头的内部连续性。该技术将任何再生移植材料纳入隧道内。本研究的目的是比较MVISTA治疗多个相邻牙龈退缩与使用绒毛膜或结缔组织移植的效果。

材料与方法

这是一项双盲随机试验。本试验共纳入18例患者。这些患者患有多个相邻的Miller I/II类牙龈退缩,他们被随机分为接受带绒毛膜的MVISTA(试验组)或结缔组织移植(CTG,对照组)。记录基线和术后一年的平均牙根覆盖(MRC)、完全牙根覆盖(CRC)和临床牙周参数,并进行组内比较。

结果

对退缩深度基线和术后12个月记录进行组内比较,发现两组之间存在显著差异(P = 0.00)。在术后情况中,试验组的退缩深度减少幅度高于对照组。然而,从统计学角度来看,差异不显著(P > 0.05)。在一年结束时,发现角化组织宽度显著增加(P < 0.05)。试验组的MRC显著高于对照组(91.33%±8.17% 对比 89.46%±11.22%)(P > 0.00)。在1年结束时,试验组的CRC为66.67%,而对照组为44.44%。试验组的牙龈表型显示出统计学上的显著改善(p = 0.004)。PD和CAL显示出统计学上无显著差异的结果(P > 0.05)。

结论

就治疗多个相邻牙龈退缩而言,带绒毛膜的MVISTA治疗可改善牙龈表型,恢复完全牙根覆盖(66.6%),并增加角化组织宽度。CTG和CM均显示出良好的牙根覆盖效果;后者可作为治疗多个退缩的替代移植材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47da/10024102/21c092f466b5/gr1.jpg

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