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带蒂结缔组织移植术与可吸收生物膜引导组织再生术治疗人类牙龈退缩缺损的比较

Subpedicle connective tissue graft versus guided tissue regeneration with bioabsorbable membrane in the treatment of human gingival recession defects.

作者信息

Trombelli L, Scabbia A, Tatakis D N, Calura G

机构信息

Department of Periodontology, School of Dentistry, University of Ferrara, Italy.

出版信息

J Periodontol. 1998 Nov;69(11):1271-7. doi: 10.1902/jop.1998.69.11.1271.

DOI:10.1902/jop.1998.69.11.1271
PMID:9848537
Abstract

The purpose of the present clinical study was to evaluate the effect of guided tissue regeneration (GTR) in comparison to subpedicle connective tissue graft (SCTG) in the treatment of gingival recession defects. A total of 12 patients, each contributing a pair of Miller's Class I or II buccal gingival recessions, was treated. According to a randomization list, one defect in each patient received a polyglycolide/lactide bioabsorbable membrane, while the paired defect received a SCTG. Treatment effect was evaluated 6 months postsurgery. Clinical recordings included full-mouth and defect-specific oral hygiene standards and gingival health, recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), and keratinized tissue width (KT). Mean RD significantly decreased from 3.1 mm presurgery to 1.5 mm at 6 months postsurgery for the GTR group (48% root coverage), and from 3.0 mm to 0.5 mm for the SCTG group (81% root coverage). RD reduction and root coverage were significantly greater in SCTG group compared to GTR group. Mean CAL gain amounted to 1.7 mm for the GTR group, and 2.3 mm in the SCTG group. No significant differences in PD changes were observed within and between groups. KT increased significantly from presurgery for both treatment groups, however gingival augmentation was significantly greater in the SCTG group compared to GTR group. Results indicate that: 1) treatment of human gingival recession defects by means of both GTR and SCTG procedures results in clinically and statistically significant improvement of the soft tissue conditions of the defect; and 2) treatment outcome was significantly better following SCTG compared to GTR in terms of recession depth reduction, root coverage, and keratinized tissue increase.

摘要

本临床研究的目的是评估引导组织再生术(GTR)与带蒂结缔组织移植术(SCTG)相比在治疗牙龈退缩缺损方面的效果。共治疗了12例患者,每位患者均有一对米勒I类或II类颊侧牙龈退缩。根据随机列表,每位患者的一个缺损接受聚乙醇酸/乳酸生物可吸收膜治疗,而配对的缺损接受SCTG治疗。术后6个月评估治疗效果。临床记录包括全口和缺损特异性的口腔卫生标准、牙龈健康状况、退缩深度(RD)、退缩宽度(RW)、探诊深度(PD)、临床附着水平(CAL)和角化组织宽度(KT)。GTR组的平均RD从术前的3.1mm显著降至术后6个月的1.5mm(牙根覆盖率48%),SCTG组从3.0mm降至0.5mm(牙根覆盖率81%)。与GTR组相比,SCTG组的RD减少和牙根覆盖率显著更高。GTR组的平均CAL增加量为1.7mm,SCTG组为2.3mm。组内和组间在PD变化方面未观察到显著差异。两个治疗组的KT均较术前显著增加,但与GTR组相比,SCTG组的牙龈增生显著更大。结果表明:1)通过GTR和SCTG手术治疗人类牙龈退缩缺损在临床上和统计学上均能显著改善缺损部位的软组织状况;2)在退缩深度减少、牙根覆盖和角化组织增加方面,SCTG治疗后的效果显著优于GTR。

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