Abdel-Fatah Reham, Elkashty Ayman, El-Sharkawy Hesham
Oral Medicine, Periodontology, Diagnosis, and Oral Radiology Depatment, Faculty of Dentistry, Mansoura University, Algomhoria St, Mansoura City, Aldakhlia, 35516, Egypt.
BMC Oral Health. 2025 May 24;25(1):780. doi: 10.1186/s12903-025-06150-8.
The buccal fat pad (BFP) is a unique, encapsulated fatty tissue that retains its volume and structure over time and contains undifferentiated mesenchymal cells. It has been used in various surgical techniques, such as closing oroantral and oronasal communications and repairing defects due to trauma or malignancy. A few years ago, the buccal fat pad was utilized as a pedicle or free soft tissue graft to treat gingival recessions. Therefore, this randomized clinical trial (RCT) was conducted to assess the effectiveness of the free buccal fat pad graft (FBPFG) compared to the de-epithelialized free gingival graft (DFGG) in conjunction with coronally advanced flap (CAF) in localized gingival recession treatment.
This RCT included 39 participants, with 20 patients receiving a coronally advanced flap (CAF) with FBPFG (Group I) and 19 patients treated with CAF and DFGG (Group II). Clinical parameters such as probing depth (PD), clinical attachment level (CAL), recession depth (RD), width of keratinized gingiva (WKG), and gingival thickness (GT) were assessed after 3- and 6 months of surgical intervention.
After 3- and 6-month follow-ups, statistically significant changes were noted between the groups in all clinical parameters. At 1st and 2nd days of surgical intervention, there was a statistically significant decrease in the values of the visual analogue scale (VAS) in group I compared to group II. Regarding dentinal hypersensitivity, there were statistically significant variations of 3- and 6-month parameters compared to baseline in the two groups. However, there were no differences between the two after the therapy.
It was proven that DFGG produces significantly better outcomes than FBPFG in treating localized gingival recession. However, FBPFG might serve as a viable alternative for mild to moderate gingival recession cases, where only a limited reduction in recession depth and modest increase in gingival thickness and width of keratinized tissues are required, with the benefit of lower donor site morbidity.
This randomized controlled clinical trial was registered on the Pan African Clinical Trials Registry and approved on 22/06/2023 (Trial no: PACTR202307891237031).
颊脂垫（BFP）是一种独特的、有包膜的脂肪组织，其体积和结构随时间保持稳定，并含有未分化的间充质细胞。它已被用于各种外科技术，如关闭口腔上颌窦和口鼻通道以及修复创伤或恶性肿瘤导致的缺损。几年前，颊脂垫被用作带蒂或游离软组织移植来治疗牙龈退缩。因此，本随机临床试验（RCT）旨在评估游离颊脂垫移植（FBPFG）与去上皮化游离龈瓣移植（DFGG）联合冠向复位瓣（CAF）治疗局限性牙龈退缩的有效性。
本RCT纳入39名参与者，20例患者接受CAF联合FBPFG治疗（I组），19例患者接受CAF联合DFGG治疗（II组）。在手术干预3个月和6个月后评估临床参数，如探诊深度（PD）、临床附着水平（CAL）、退缩深度（RD）、角化龈宽度（WKG）和牙龈厚度（GT）。
在3个月和6个月的随访后，两组在所有临床参数上均有统计学显著变化。在手术干预的第1天和第2天，I组视觉模拟量表（VAS）值与II组相比有统计学显著降低。关于牙本质过敏，两组在3个月和6个月时的参数与基线相比有统计学显著差异。然而，治疗后两组之间没有差异。
已证明DFGG在治疗局限性牙龈退缩方面比FBPFG产生显著更好的效果。然而，FBPFG可能是轻度至中度牙龈退缩病例的可行替代方案，对于此类病例，仅需要有限程度的退缩深度减少以及角化组织的牙龈厚度和宽度适度增加，且供区发病率较低。
本随机对照临床试验已在泛非临床试验注册中心注册，并于2023年6月22日获得批准（试验编号：PACTR202307891237031）。
