Wang Zhitao, Zhai Tianyang
Int J Periodontics Restorative Dent. 2023 Aug 8. doi: 10.11607/prd.5379.
This study aimed to compare the efficacy of acellular dermal matrix (ADM) versus connective tissue graft (CTG) for root coverage in patients with gingival recession. Randomized controlled trials (RCTs) on the comparison of ADM with CTG in adult patients with gingival recession were searched in multiple databases updated on 15th May 2020. The quality of studies was evaluated using the upgraded Jadad scale. Included studies were assessed for percent root coverage (PRC), clinical attachment level (CAL), keratinized tissue (KT), probing depth (PD), recession width (RW) and recession depth (RD). Weighted mean difference (WMD) was used as the statistics for measurement data and the effect sizes were expressed as 95% confidence intervals (CI). Totally 24 RCTs were eligible for the final analysis. The patients accepting ADM had a higher gain in CAL (WMD: 0.250, 95%CI: 0.030-0.470, P=0.026) but a smaller gain in KT width (WMD: -0.440, 95%CI: -0.629--0.252, P<0.001) than those receiving CTG. No significant differences were found between the patients accepting ADM and those undergoing CTG in PRC (WMD: -1.608, 95%CI: -3.491-0.275, P=0.094), PD (WMD: 0.066, 95%CI: -0.005-0.137, P=0.067), RW (WMD: 0.065, 95%CI: -0.098-0.228, P=0.437) and RD (WMD: 0.109, 95%CI: -0.095-0.314, P=0.294). Overall, the ADM treatment for patients with gingival recession may be superior to CTG in gaining CAL, but CTG has a significant advantage over ADM in gaining KT width.
本研究旨在比较脱细胞真皮基质（ADM）与结缔组织移植（CTG）对牙龈退缩患者牙根覆盖的疗效。在2020年5月15日更新的多个数据库中检索了关于ADM与CTG在成年牙龈退缩患者中比较的随机对照试验（RCT）。使用升级后的Jadad量表评估研究质量。纳入的研究评估了牙根覆盖百分比（PRC）、临床附着水平（CAL）、角化组织（KT）、探诊深度（PD）、退缩宽度（RW）和退缩深度（RD）。加权平均差（WMD）用作测量数据的统计量，效应大小以95%置信区间（CI）表示。共有24项RCT符合最终分析的条件。接受ADM治疗的患者CAL增加幅度更大（WMD：0.250，95%CI：0.030 - 0.470，P = 0.026），但KT宽度增加幅度小于接受CTG的患者（WMD： - 0.440，95%CI： - 0.629 - - 0.252，P < 0.001）。在接受ADM治疗的患者与接受CTG治疗的患者之间，PRC（WMD： - 1.608，95%CI： - 3.491 - 0.275，P = 0.094）、PD（WMD：0.066，95%CI： - 0.005 - 0.137，P = 0.067）、RW（WMD：0.065，95%CI： - 0.098 - 0.228，P = 0.437）和RD（WMD：0.109，95%CI： - 0.095 - 0.314，P = 0.294）方面未发现显著差异。总体而言，ADM治疗牙龈退缩患者在增加CAL方面可能优于CTG，但CTG在增加KT宽度方面比ADM具有显著优势。
