Singh Asi Kanwarjit, Mahajan Ajay, Rayast Deepa
Department of Periodontology, Himachal Pradesh Government Dental College and Hospital, Shimla, Himachal Pradesh, India.
Department of Dental Surgery, Raipur Institute of Medical Science, Chhattisgarh, India.
Natl J Maxillofac Surg. 2024 May-Aug;15(2):283-287. doi: 10.4103/njms.njms_187_22. Epub 2024 Jul 24.
Various surgical techniques are described in the literature to manage gingival recession defects but the histopathologic evidence to support the current available techniques, is scarce. Recently periosteal pedicle graft (PPG) has proven to be an effective treatment option to treat gingival recession defects (GRD) with results comparable to subepithelial connective tissue graft (SCTG).
The present histopathological study was done to evaluate the healing pattern of periosteal pedicle autogenous graft along with coronally advanced flap in the treatment of gingival recession defects.
The present study was performed on 10 sites in 5 rabbits. Two sites were selected in each animal and gingival recession defects were surgically created and then treated using periosteal pedicle pedicle graft along with coronally advanced flap procedure. Healing pattern was assessed histopathologically at pre-defined intervals till 6 months.
On the 7th day of healing, dilated blood vessels with inflammatory cells were seen, while rudimentary rete-pegs appeared on 14th day. Between 3 months to 6 months, advanced histological repair with connective tissue organization with initiation of junctional epithelium, cementum and bone formation were observed.
Gingival recession defects treated with PPG had evidences of regeneration of cementum, bone and periodontal ligament fibers with new connective tissue attachment.
文献中描述了多种治疗牙龈退缩缺损的手术技术,但支持当前可用技术的组织病理学证据很少。最近,骨膜蒂移植(PPG)已被证明是治疗牙龈退缩缺损(GRD)的一种有效治疗选择,其结果与上皮下结缔组织移植(SCTG)相当。
进行本组织病理学研究以评估骨膜蒂自体移植联合冠向推进瓣治疗牙龈退缩缺损的愈合模式。
本研究在5只兔子的10个部位进行。每只动物选择两个部位,手术制造牙龈退缩缺损,然后使用骨膜蒂移植联合冠向推进瓣手术进行治疗。在预定的间隔时间直至6个月时,通过组织病理学评估愈合模式。
在愈合的第7天,可见血管扩张并有炎症细胞,而在第14天出现了原始的 rete 嵴。在3个月至6个月之间,观察到具有结缔组织组织的高级组织学修复,并开始形成结合上皮、牙骨质和骨。
用PPG治疗的牙龈退缩缺损有牙骨质、骨和牙周韧带纤维再生以及新的结缔组织附着的证据。