Zaaya Salma, Elbattawy Weam, Yusri Sarah, Fawzy El-Sayed Karim M
Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany.
J Periodontal Res. 2024 Oct;59(5):907-917. doi: 10.1111/jre.13271. Epub 2024 Apr 25.
This randomized trial assessed for the first time the efficacy of coronally advanced flap (CAF) followed by micro-needling (MN) in contrast to CAF with acellular dermal matrix (ADM) on gingival thickness (GT, primary outcome), keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), recession depth (RD), recession width (RW), recession reduction (Rec-Red), complete root coverage (CRC) and percentage of root coverage (all secondary outcomes) in management of RT1 gingival recession in patients with thin gingival phenotype.
A total of 24 patients (n = 24) with a thin gingival phenotype and single RT1 gingival recession in the aesthetic zone were randomly allocated to test- (CAF + MN; n = 12) or control group (CAF + ADM; n = 12). All clinical parameters were evaluated at baseline, 3 and 6 months.
Both groups independently demonstrated significant gain in GT, RW, RD, CAL, PD, Rec-Red, CRC and percentage of root coverage, with reduced PI and BOP (p < .05) at 3 and 6 months, without intergroup differences (p > .05). At 6 months, KTW gain was significantly higher in CAF + MN (5.08 ± 0.9 mm) than in CAF + ADM-group (4.25 ± 1.06 mm; p < .05). Stepwise linear regression model with GT as dependent variable showed that base-line GT was the only statistically significant predictor for GT with a direct correlation between base-line GT and GT after 6 months.
CAF followed by MN could represent a promising graft-less approach for increasing gingival thickness, comparable to CAF with ADM, with superior keratinized tissue width improvement, in the treatment of RT1 recession defects in patients with thin gingival phenotype.
本随机试验首次评估了冠向推进瓣（CAF）联合微针治疗（MN）与CAF联合无细胞真皮基质（ADM）相比，对薄龈型患者RT1牙龈退缩的牙龈厚度（GT，主要结局）、角化组织宽度（KTW）、临床附着水平（CAL）、探诊深度（PD）、退缩深度（RD）、退缩宽度（RW）、退缩减少量（Rec-Red）、完全根覆盖（CRC）和根覆盖百分比（所有次要结局）的疗效。
共有24例薄龈型且美学区域有单个RT1牙龈退缩的患者被随机分配至试验组（CAF + MN；n = 12）或对照组（CAF + ADM；n = 12）。所有临床参数在基线、3个月和6个月时进行评估。
两组在3个月和6个月时，GT、RW、RD、CAL、PD、Rec-Red、CRC和根覆盖百分比均有显著增加，探诊指数（PI）和探诊出血（BOP）降低（p < 0.05），组间无差异（p > 0.05）。在6个月时，CAF + MN组的KTW增加量（5.08 ± 0.9 mm）显著高于CAF + ADM组（4.25 ± 1.06 mm；p < 0.05）。以GT为因变量的逐步线性回归模型显示，基线GT是GT的唯一具有统计学意义的预测因子，基线GT与6个月后的GT呈直接相关。
对于薄龈型患者的RT1退缩缺损治疗，CAF联合MN可能是一种有前景的无移植方法，可增加牙龈厚度，与CAF联合ADM相当，且角化组织宽度改善更优。
