Skierska Izabela, Górski Bartłomiej, Fus Łukasz
Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Warsaw, Poland.
Department of Pathology, Medical University of Warsaw, Warsaw, Poland.
J Periodontol. 2024 Nov;95(11):1060-1072. doi: 10.1002/JPER.24-0093. Epub 2024 May 29.
This study evaluated the influence of the adjunctive application of a cross-linked hyaluronic acid (HA) in the treatment of multiple gingival recessions, using a modified coronally advanced tunnel (MCAT) technique and subepithelial connective tissue graft (SCTG) (MCAT+SCTG±HA).
A randomized, split-mouth, double-masked comparison of the effects of MCAT+HA+SCTG (test) versus MCAT+SCTG (control) in the treatment of multiple, contralateral gingival recessions with clinical, esthetic, and histological evaluations was carried out. All samples were stained with hematoxylin and eosin, Masson's trichrome, Verhoeff-Van Gieson, and Alcian blue stain for semiquantitative evaluation. The primary outcome variable was 12-month mean root coverage (MRC).
Twenty-four patients with 266 gingival recessions received both control and test treatments (133 recessions per group). 12-month MRC of the MCAT+HA+SCTG group was not significantly different from the MCAT+SCTG group with 84.32%± 34.46% and 85.71%± 36.43%, respectively (p = 0.991). Both treatment modes produced favorable esthetic outcomes (root coverage esthetic score [RES] 9.51± 1.01 tests vs. 9.26± 1.10 controls, p = 0.7292). However, the application of HA improved soft tissue texture (p = 0.0091). The remaining end point measures did not differ significantly between groups. Histological evaluation showed a significantly greater number of elastic fibers and a moderate increase in collagen fiber density in biopsy samples taken from the test sides when compared to the control sides (p = 0.0419 and p = 0.300, respectively).
MCAT+SCTG is an effective procedure in the treatment of multiple recession Type 1 (RT1) and RT2 recessions. There were no statistically significant differences in evaluated clinical treatment outcomes in the MCAT+HA+SCTG group compared to the MCAT+SCTG group within a period of 12 months. The application of HA increased collagen and elastic fiber density.
本研究评估了交联透明质酸（HA）辅助应用于改良冠向推进隧道（MCAT）技术和上皮下结缔组织移植（SCTG）（MCAT+SCTG±HA）治疗多处牙龈退缩的影响。
对MCAT+HA+SCTG（试验组）与MCAT+SCTG（对照组）治疗多处对侧牙龈退缩的效果进行随机、分口、双盲比较，并进行临床、美学和组织学评估。所有样本用苏木精和伊红、马松三色染色、韦尔霍夫-范吉森染色和阿尔辛蓝染色进行半定量评估。主要结局变量为12个月平均牙根覆盖量（MRC）。
24例患有266处牙龈退缩的患者接受了对照组和试验组治疗（每组133处退缩）。MCAT+HA+SCTG组的12个月MRC与MCAT+SCTG组无显著差异，分别为84.32%±34.46%和85.71%±36.43%（p=0.991）。两种治疗方式均产生了良好的美学效果（牙根覆盖美学评分[RES]试验组为9.51±1.01，对照组为9.26±1.10，p=0.7292）。然而，HA的应用改善了软组织质地（p=0.0091）。其余终点指标在两组间无显著差异。组织学评估显示，与对照组相比，试验组活检样本中的弹性纤维数量显著增加，胶原纤维密度适度增加（分别为p=0.0419和p=0.300）。
MCAT+SCTG是治疗多处1型退缩（RT1）和RT2型退缩的有效方法。与MCAT+SCTG组相比，MCAT+HA+SCTG组在12个月内评估的临床治疗结果无统计学显著差异。HA的应用增加了胶原纤维和弹性纤维密度。
