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应用富白细胞血小板纤维蛋白联合冠向复位瓣治疗多个相邻牙龈退缩:一项 12 个月的分侧对照随机临床试验。

Treatment of multiple adjacent gingival recessions using leucocyte- and platelet-rich fibrin with coronally advanced flap: a 12-month split-mouth controlled randomized clinical trial.

机构信息

Department of Periodontology, Institute of Health Sciences, Marmara University, Istanbul, Türkiye.

Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, 34854, Türkiye.

出版信息

Clin Oral Investig. 2024 May 1;28(5):291. doi: 10.1007/s00784-024-05694-3.

Abstract

OBJECTIVE

This split-mouth randomized study aimed to assess efficacy of leucocyte-platelet-rich fibrin (L-PRF) versus connective tissue graft (CTG) in achieving root coverage (RC) for multiple adjacent gingival recessions (MAGRs) throughout 12-month period.

MATERIALS AND METHODS

The study enrolled 59 teeth from 12 patients with Miller Class I MAGRs ≥ 2 mm on bilateral or contralateral sides. Patients were randomly assigned to receive coronally advanced flap (CAF) with either CTG (control) or L-PRF (test) treatment. Various parameters, including plaque and gingival index, clinical attachment level, recession depth, probing depth, recession width (RW), papilla width (PW), keratinized tissue width (KTW), gingival thickness (GT), percentage of RC, complete root coverage (CRC), and location of the relative gingival margin concerning the cemento-enamel junctions (GMCEJ) after CAF, were recorded at baseline, 3-, 6-, and 12-months post-surgery. On June 29, 2021 the study was registred to ClinicalTrials.gov (NCT04942821).

RESULTS

Except KTW and GT gain, all clinical parameters, RC, and CRC were similar between the groups at all follow-up periods (p > 0.05). The higher GT and KTW gains were detected in the control group compared to test group at 12 months (p < 0.05). Both RC and CRC were positively associated with initial PW and GMCEJ, but negatively with initial RW (p < 0.05).

CONCLUSIONS

The current study concludes that L-PRF were equally effective as CTG in treating MAGRs in terms of RC and CRC. Additionally, RC and CRC outcomes appeared to be influenced by GMCEJ, PW, and RW.

CLINICAL RELEVANCE

L-PRF could represent a feasible substitute for CTG in treating MAGRs.

摘要

目的

本分组、随机研究旨在评估富白细胞纤维蛋白(L-PRF)与结缔组织移植物(CTG)在 12 个月期间治疗多发性邻面牙龈退缩(MAGR)的根面覆盖(RC)疗效。

材料与方法

该研究纳入了 12 例双侧或对侧 Miller 分级 I MAGR  ≥ 2mm 的 59 颗牙齿的患者。患者被随机分配接受改良结缔组织瓣(CAF)加 CTG(对照组)或 L-PRF(实验组)治疗。在基线、术后 3、6 和 12 个月时,记录菌斑和牙龈指数、临床附着水平、龈退缩深度、探诊深度、龈退缩宽度(RW)、龈乳头宽度(PW)、角化组织宽度(KTW)、牙龈厚度(GT)、RC 百分比、完全根面覆盖(CRC)以及 CAF 后相对龈缘相对于牙釉质牙骨质界(GMCEJ)的位置。2021 年 6 月 29 日,该研究在 ClinicalTrials.gov 注册(NCT04942821)。

结果

除 KTW 和 GT 增加外,两组在所有随访期的所有临床参数、RC 和 CRC 均无差异(p>0.05)。与实验组相比,对照组在 12 个月时 GT 和 KTW 增加更高(p<0.05)。RC 和 CRC 与初始 PW 和 GMCEJ 呈正相关,但与初始 RW 呈负相关(p<0.05)。

结论

本研究表明,在治疗 MAGR 方面,L-PRF 与 CTG 一样有效,可作为 RC 和 CRC。此外,RC 和 CRC 的结果似乎受 GMCEJ、PW 和 RW 的影响。

临床意义

L-PRF 可作为治疗 MAGR 的 CTG 替代物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc4f/11062988/41f7a18d8034/784_2024_5694_Fig1_HTML.jpg

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