Kumari Khushboo, Nath Barsha, Kumar Amrit, Chhabada Amarpal Kour, Kumari Rosy, Prakash Gyan
Department of Oral Pathology, Buddha Institute of Dental Sciences and Hospital, Patna, IND.
Department of Periodontology and Implantology, Buddha Institute of Dental Sciences and Hospital, Patna, IND.
Cureus. 2023 Sep 6;15(9):e44758. doi: 10.7759/cureus.44758. eCollection 2023 Sep.
Being an autologous graft, a subepithelial connective tissue (SECT) graft shows more predictable root coverage better than other techniques. Hence, it is most likely to be widely used for recession treatment. During root planing, a smear layer forms on the root surface that cannot be removed by water or saline rinsing. To remove this smear layer, root biomodification agents are widely used. The present study was conducted to assess the efficacy of an SECT graft for root coverage with and without root biomodification.
This study included 20 patients with no gender predilection, with an age range of 24-36 years and a mean age of 27.6 ± 4.24 years. The chosen range facilitated the acquisition of data in a relatively homogeneous population, minimizing the confounding effects of factors such as aging-related tissue changes or early-onset periodontal issues. All 40 sites were treated with the SECT and coronally advanced flap. Root conditioning in controls was done with distilled saline and tested using 24% ethylenediaminetetraacetic acid (EDTA) gel (Maquira; STM Meditech, Kerala). At baseline and at one, three, and six months postoperatively, pocket depth (PD) and clinical attachment levels (CALs) were assessed at four sites using a UNC-15 probe, and from the gingival margin to the cementoenamel junction (CEJ), the vertical recession was assessed.
For the buccal surface, CALs were reduced significantly (p < 0.001). Following root conditioning with 24% EDTA, no difference was seen in the CAL in the control and test group either buccally or interproximally with a p-value of greater than 0.05. For PD, following a SECT graft or root conditioning, no significant change was observed in the buccal or interproximal region (p > 0.05). The vertical recession was significantly reduced with a p-value of less than 0.001 and depth coverage of 97.5%. The difference between the two groups was statistically non-significant (p > 0.05). The root surface coverage decreased significantly from 16.6 ± 2.8 to 0.45 ± 0.4 from baseline to six months, which was statistically significant (p < 0.001). This intergroup difference was non-statistical (p > 0.05).
The present study concludes that the use of an SECT graft in root coverage can significantly improve the CAL, root surface area, and vertical recession both with and without root biomodification. We conclude that there is a significant decrease in the probing depth following SECT grafting and with root biomodification.
作为一种自体移植物，上皮下结缔组织（SECT）移植在牙根覆盖方面比其他技术表现出更可预测的效果，因此最有可能被广泛用于治疗牙龈退缩。在根面平整过程中，根面会形成一层玷污层，用水或生理盐水冲洗无法去除。为了去除这层玷污层，根生物改性剂被广泛使用。本研究旨在评估有无根生物改性情况下SECT移植在牙根覆盖方面的疗效。
本研究纳入20例患者，无性别倾向，年龄范围为24 - 36岁，平均年龄为27.6±4.24岁。选择该年龄范围有助于在相对同质的人群中获取数据，将与年龄相关的组织变化或早发性牙周问题等因素的混杂影响降至最低。所有40个位点均采用SECT和冠向推进瓣进行治疗。对照组用蒸馏水冲洗进行牙根预处理，并使用24%乙二胺四乙酸（EDTA）凝胶（Maquira；STM Meditech，喀拉拉邦）进行测试。在基线以及术后1个月、3个月和6个月时，使用UNC - 15探针在4个位点评估牙周袋深度（PD）和临床附着水平（CAL），并从牙龈边缘至牙骨质釉质界（CEJ）评估垂直退缩情况。
对于颊面，CAL显著降低（p < 0.001）。用24% EDTA进行牙根预处理后，对照组和试验组在颊侧或邻面的CAL均无差异，p值大于0.05。对于PD，在进行SECT移植或牙根预处理后，颊侧或邻面区域均未观察到显著变化（p > 0.05）。垂直退缩显著降低，p值小于0.001，深度覆盖为97.5%。两组之间的差异无统计学意义（p > 0.05）。从基线到6个月，根面覆盖率从16.6±2.8显著降至0.45±0.4，具有统计学意义（p < 0.001）。这种组间差异无统计学意义（p > 0.05）。
本研究得出结论，无论有无根生物改性，在牙根覆盖中使用SECT移植均可显著改善CAL、根表面积和垂直退缩。我们得出结论，SECT移植及根生物改性后探诊深度显著降低。
