Halim Felita Clarissa, Soeroso Yuniarti, Hutomo Dimas Ilham, Harsas Nadhia Anindhita, Sulijaya Benso
Resident of Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
Heliyon. 2025 Feb 12;11(4):e42656. doi: 10.1016/j.heliyon.2025.e42656. eCollection 2025 Feb 28.
Gingival recession associated with non-carious cervical lesions (NCCL) is a common finding in the majority of the population. Sometimes, periodontal surgery using connective tissue graft (CTG), which is the gold standard in the treatment of gingival recession, needs to be combined with adhesive restoration to restore sufficient convergence profile. Thus, this systematic review aims to evaluate periodontal-restorative therapy using CTG combined restorative material to treat gingival recession with NCCL.
This study, following PRISMA guidelines, involved a literature search across PubMed, Scopus, Embase, and Google Scholar for articles from 2014 to June 2023 using keywords related to connective tissue grafts, cervical lesions, and gingival recession combined using AND/OR as Boolean operator. It included randomized controlled trials (RCTs), prospective studies, case series, or reports involving adult subjects with gingival recession and non-carious cervical lesions treated with CTG and restorative care, with at least 6 months of follow-up. Data were independently extracted by two reviewers, with discrepancies resolved by consensus. Risk of bias was assessed using the Cochrane RoB 2.0 tool, ROBINS-I, and the JBI Critical Appraisal tool.
8 out of 1175 publications were selected for final analysis. Selected publications consist of randomized clinical trials, prospective studies, case series, and a case report. The restorative materials used include resin composite, resin-modified glass ionomer (RMGI), and giomers. It has been reported that the restoration showed no negative effect on the surrounding gingival tissue after surgical treatment. Resin composites and RMGI showed similar clinical results as restorative materials whereas giomers was reported to be less effective for the combined treatment of gingival recession associated with NCCL.
Therefore, the combination of surgical and restorative treatment provides stable clinical outcome and good emergence profile in gingival recession associated with NCCL. Root coverage with CTG is successful on teeth with cervical fillings.
与非龋性颈部病变（NCCL）相关的牙龈退缩在大多数人群中是常见现象。有时，使用结缔组织移植（CTG）的牙周手术是治疗牙龈退缩的金标准，需要与粘结修复相结合以恢复足够的聚合度。因此，本系统评价旨在评估使用CTG联合修复材料治疗伴有NCCL的牙龈退缩的牙周修复治疗。
本研究遵循PRISMA指南，通过在PubMed、Scopus、Embase和谷歌学术上进行文献检索，使用与结缔组织移植、颈部病变和牙龈退缩相关的关键词，并以AND/OR作为布尔运算符组合，检索2014年至2023年6月的文章。纳入的研究包括随机对照试验（RCT）、前瞻性研究、病例系列或报告，研究对象为接受CTG和修复治疗的伴有牙龈退缩和非龋性颈部病变的成年受试者，随访时间至少6个月。数据由两名 reviewers 独立提取，分歧通过协商解决。使用Cochrane RoB 2.0工具、ROBINS-I和JBI批判性评价工具评估偏倚风险。
1175篇出版物中有8篇被选入最终分析。入选的出版物包括随机临床试验、前瞻性研究、病例系列和一篇病例报告。使用的修复材料包括树脂复合材料、树脂改性玻璃离子（RMGI）和聚酸改性复合树脂。据报道，修复治疗后对周围牙龈组织没有负面影响。树脂复合材料和RMGI作为修复材料显示出相似的临床效果，而据报道聚酸改性复合树脂在联合治疗与NCCL相关的牙龈退缩方面效果较差。
因此，手术和修复治疗相结合在伴有NCCL的牙龈退缩中提供了稳定的临床结果和良好的外形。使用CTG进行牙根覆盖在有颈部充填物的牙齿上是成功的。
