Lee Jae-Hong, Kim Yeon-Tae
Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Korea.
Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
J Periodontal Implant Sci. 2025 Jan 24. doi: 10.5051/jpis.2400760038.
This study was conducted to evaluate the 3-year predictability and validity of the modified tunnel technique, both with and without the use of enamel matrix derivative (EMD), for treating deep and narrow gingival recession defects (GRDs) in the mandibular anterior region.
Overall, 31 GRDs were treated using the modified tunnel technique combined with subepithelial connective tissue graft. The cohort was divided into 2 groups: one with the adjunctive use of EMD (n=16) and the other without EMD (n=15). Clinical outcomes, including recession depth (RD), keratinized tissue width (KTW), mean root coverage (MRC), and complete root coverage (CRC), were evaluated at baseline, as well as at 6 months, 1 year, and 3 years postoperatively. Patient discomfort was assessed with a self-report questionnaire 2 weeks after surgery.
At the 3-year follow-up, no statistically significant differences were observed between the 2 treatment modalities in clinical parameters, including RD (EMD, -6.47±2.23 mm; non-EMD, -5.10±3.23 mm), KTW (EMD, 1.03±0.96 mm; non-EMD, 1.00±1.02 mm), MRC (EMD, 86.62%±21.18%; non-EMD, 80.24%±38.73%), and CRC (EMD, 62.5%; non-EMD, 73.3%). Furthermore, no significant differences were found between the groups in terms of early and subjective postoperative discomfort, including pain and swelling.
Within the limitations of this study, the modified tunnel technique, whether used alone or in conjunction with EMD, demonstrated benefits in the treatment and maintenance of deep and narrow GRDs.
本研究旨在评估改良隧道技术在使用和不使用釉基质衍生物（EMD）的情况下，治疗下颌前牙区深部窄型牙龈退缩缺损（GRD）的3年可预测性和有效性。
总共31例GRD采用改良隧道技术联合上皮下结缔组织移植进行治疗。该队列分为2组：一组辅助使用EMD（n = 16），另一组不使用EMD（n = 15）。在基线以及术后6个月、1年和3年时评估临床结果，包括退缩深度（RD）、角化组织宽度（KTW）、平均牙根覆盖（MRC）和完全牙根覆盖（CRC）。术后2周通过自我报告问卷评估患者不适情况。
在3年随访时，两种治疗方式在临床参数方面未观察到统计学上的显著差异，包括RD（EMD组，-6.47±2.23 mm；非EMD组，-5.10±3.23 mm）、KTW（EMD组，1.03±0.96 mm；非EMD组，1.00±1.02 mm）、MRC（EMD组，86.62%±21.18%；非EMD组，80.24%±38.73%）和CRC（EMD组，62.5%；非EMD组，73.3%）。此外，两组在术后早期和主观不适方面，包括疼痛和肿胀，均未发现显著差异。
在本研究的局限性范围内，改良隧道技术无论是单独使用还是与EMD联合使用，在治疗和维持深部窄型GRD方面均显示出益处。
