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用于局限性牙龈退缩的牙龈单位移植术:一项双侧对照随机临床试验。

Gingival unit grafts for localized gingival recession: A split mouth randomized controlled trial.

作者信息

Katti Neelima, Satpathy Anurag, Mohanty Devapratim, Pape Reddy Saravanan Sampoornam, Agrawal Poonam, Pradhan Shib Shankar

机构信息

Assistant Professor (Periodontics), SCB Dental College & Hospital, Cuttack, Odisha, India.

Professor (Periodontics & Oral Implantology), Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India.

出版信息

Med J Armed Forces India. 2024 Jul-Aug;80(4):466-474. doi: 10.1016/j.mjafi.2024.05.002. Epub 2024 Jun 21.

Abstract

BACKGROUND

The interaction between the recipient area and the graft is one of the key factors in the success of periodontal plastic surgery. This randomized controlled, split-mouth, double-blinded clinical trial aimed to compare the clinical and aesthetic outcomes of epithelialized palatal graft (EPG) and gingival unit graft (GUG) in achieving root coverage in localized (Recession Type 1) RT1 recession defects.

METHODS

Twenty participants with forty bilateral recession defects randomly received EPG or GUG surgical treatment modalities for each of the recession defects. Clinical measurements recorded at baseline and after six months included recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), and the average width of mesial and distal interdental papilla (aWIDP).

RESULTS

There was a statistically significant greater mean root coverage (MRC) percentage at GUG sites (80.68 ± 16.12%) in comparison to EPG sites (71.05 ± 17.23%) ( = 0.01). The treatment satisfaction ( = 0.009) and aesthetic satisfaction ( < 0.001) experienced were significantly better for GUG as compared to EPG. The regression model (  = 0.56) significantly predicted MRC percentage in GUG sites with baseline RD ( = -12.49;  = 0.02) and aWIDP ( = -9.31;  = 0.02).

CONCLUSION

GUG showed a better MRC, aesthetics and increased KTW. Root coverage procedures often need to suffice the dual objective of coverage and aesthetics at the same time. GUG is a simple modification of the conventional EPG that can provide better clinical and aesthetic outcomes.

摘要

背景

受植区与移植物之间的相互作用是牙周整形手术成功的关键因素之一。这项随机对照、分口、双盲临床试验旨在比较上皮化腭部移植物(EPG)和牙龈单位移植物(GUG)在治疗局限性(1型退缩)RT1退缩缺损以实现牙根覆盖方面的临床和美学效果。

方法

20名有40处双侧退缩缺损的参与者,其每一处退缩缺损随机接受EPG或GUG手术治疗方式。在基线期和6个月后记录的临床测量指标包括退缩深度(RD)、退缩宽度(RW)、探诊深度(PD)、临床附着水平(CAL)、角化组织宽度(KTW)以及近中与远中牙间乳头的平均宽度(aWIDP)。

结果

与EPG部位(71.05±17.23%)相比,GUG部位的平均牙根覆盖(MRC)百分比在统计学上显著更高(80.68±16.12%)(P = 0.01)。与EPG相比,GUG的治疗满意度(P = 0.009)和美学满意度(P < 0.001)明显更高。回归模型(R² = 0.56)通过基线RD(β = -12.49;P = 0.02)和aWIDP(β = -9.31;P = 0.02)显著预测了GUG部位的MRC百分比。

结论

GUG显示出更好的MRC、美学效果以及增加的KTW。牙根覆盖手术通常需要同时满足覆盖和美学这两个双重目标。GUG是对传统EPG的一种简单改良,可提供更好的临床和美学效果。

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