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评价富血小板纤维蛋白基质与黏膜下结缔组织移植在牙根部覆盖中的疗效:采用改良 Ruben 技术的比较研究。

Evaluating the Efficacy of Platelet-Rich Fibrin Matrix versus Subepithelial Connective Tissue Grafts in Dental Root Coverage: A Comparative Study Using Modified Ruben's Technique.

机构信息

Department of Periodontics, SRM Dental College, Ramapuram, Chennai, India.

Department of Periodontics, SRM Dental College, Chennai, India.

出版信息

Med Sci Monit. 2023 Oct 3;29:e941473. doi: 10.12659/MSM.941473.

DOI:10.12659/MSM.941473
PMID:37786246
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10559832/
Abstract

BACKGROUND Dental root coverage, crucial in managing gingival recessions, traditionally utilizes subepithelial connective tissue grafts. However, this approach has limitations such as donor site morbidity and graft availability. Recent studies have introduced platelet-rich fibrin (PRF) as an alternative, leveraging its regenerative potential and growth factors. Despite the promise, comparative assessments between PRF and conventional grafts remain limited. This research probes whether PRF, when used beneath a modified Ruben's mixed flap, could provide comparable or superior dental root coverage than a subepithelial connective tissue graft. MATERIAL AND METHODS We enrolled 30 patients exhibiting Miller's class I and II recession in this comparative case series. Patients were randomly assigned to receive either a connective tissue graft (15 patients) or a PRF matrix (15 patients), both covered by a modified Ruben's mixed flap. RESULTS Clinical parameters, including full mouth plaque scores, bleeding scores, probing sulcus depth, clinical attachment level, gingival position assessment, width, and thickness of attached gingiva, were assessed in both the control and test groups at baseline, 6 months, and 12 months post-surgery. Significant differences were observed at all intervals.At the 12-month mark, the control group (connective tissue graft) achieved 91% complete root coverage, while the test group (PRF matrix) achieved 86%. However, this difference was not statistically significant. CONCLUSIONS The study outcomes suggest comparable gains in root coverage and attached gingiva between the connective tissue graft and PRF matrix groups. Thus, the results support our hypothesis that a subepithelial PRF matrix can serve as a viable alternative to a subepithelial connective tissue graft for treating dental root coverage.

摘要

背景

在处理牙龈退缩时,牙本质覆盖至关重要,传统上使用上皮下结缔组织移植物。然而,这种方法存在供体部位发病率和移植物可用性等限制。最近的研究引入了富含血小板的纤维蛋白(PRF)作为一种替代方法,利用其再生潜力和生长因子。尽管有希望,但 PRF 与传统移植物之间的比较评估仍然有限。本研究探讨了在改良的 Ruben 混合瓣下使用 PRF 是否可以提供与上皮下结缔组织移植物相当或更好的牙本质覆盖。

材料和方法

我们将 30 名患有 Miller 类 I 和 II 型退缩的患者纳入本比较病例系列研究。患者被随机分为接受结缔组织移植物(15 名患者)或 PRF 基质(15 名患者),两者均由改良的 Ruben 混合瓣覆盖。

结果

在基线、6 个月和 12 个月手术后,对对照组和试验组的所有患者进行了临床参数评估,包括全口菌斑评分、出血评分、探查龈沟深度、临床附着水平、牙龈位置评估、附着龈的宽度和厚度。在所有间隔时间都观察到显著差异。在 12 个月时,对照组(结缔组织移植物)实现了 91%的完全根覆盖,而试验组(PRF 基质)实现了 86%。然而,这种差异没有统计学意义。

结论

研究结果表明,在结缔组织移植物和 PRF 基质组之间,根覆盖和附着龈的获得具有可比性。因此,结果支持我们的假设,即上皮下 PRF 基质可以作为上皮下结缔组织移植物治疗牙本质覆盖的可行替代物。

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