冠向复位瓣术治疗牙龈退缩的临床研究

Coronally positioned flap procedure in the treatment of human gingival recession

目的：单纯冠向复位瓣技术（Coronally positioned flap,CPF）与冠向复位瓣技术联合引导组织再生技术（guided tissue regeneration,GTR）治疗牙龈退缩临床效果的比较。方法：选择牙弓两侧均有唇或颊侧牙龈退缩的病人20例（Miller分度Ⅰ或Ⅱ度,2.5mm〈牙龈退缩≤5mm）,将每位病人两侧患牙随机分为2组行冠向复位瓣术,其中一组放置可吸收性膜（GTR组）,另一组不放置膜（CPF组）,分别于术前、术后3个月、术后6个月测量牙龈退缩的深度（RD）,牙龈退缩的宽度（RW）,探诊深度（PD）和临床附着水平（CAL）。结果：两种治疗方法都获得了较多的根面覆盖。术后6个月,CPF组平均获得了2.6mm的根面覆盖,覆盖率为72.2%;GTR组平均获得了2.1mm的根面覆盖,覆盖率为55.3%,两组与治疗前相比,在RD、CAL、RW方面,均有统计学意义（P〈0.05）;CPF组PD较术前有明显改善（P〈0.05）,而GTR组较术前无统计学差异（P〉0.05）;两组间的CAL、PD结果无统计学差异（P〉0.05）;RD、RW有统计学差异（P〈0.05）;结论：冠向复位瓣技术治疗2.5~5mm的牙龈退缩可在垂直和水平方向获得更多的根面覆盖,与冠向复位瓣技术联合引导组织再生技术相比具有一定的临床优越性。

AIM ：To compare the clinical outcome following treatment of local gingival recessions by coronally positioned flap with a bioabsorbable membrane or by a coronally positioned flap procedure alone. METHODS： Twenty patients with buccal bilateral Miller Class I or Class II gingival recession defects were treated randomly by coro- nally positioned flap with a bioabsorbable membrane or a coronally positioned flap alone （20 sites）. The treatment sites were selected randomly. Twenty sites in the membrane group and 20 sites in the non - membrane group were examinated at baseline, and at 3 and 6 months postoperatively. Clinical variables included the apical extent of the gingival recession （ RD）, the width of the gingival recession （RW） at the cemento - enamel junction （ CEJ）, the probing depth （PD） and the clinical attachment level （CAL）. RESULTS： Both treatments resulted in a significant gain of root coverage（ P 〈 0.001 ） , an average of 2.6ram in the non- membrane group and 2. lmm in the membrane group at the 6 - month. The rate of root coverage was 72.2% and 55.3% respectively. Six months after treatment, a statistical difference could be found when the results of RD, RWand CAL were compared with those before operations in the two groups （P 〈 0.05）. In the results of PD, statistical difference could be found in the membrane group but non in the non - membrane group（P 〉 0.05 ）. Statistical difference could be found in the results of PD, CAL but non in the results of RD and RW between two groups. CONCLUSION： Compared with coronally positioned flap combined with a bioabsor-bable membrane , coronally positioned flap procedure alone can get more root coverage in vertical and horizontal directions. The coronally positioned flap operation offers a predictable and simple approach as a root coverage procedure for 2.5mm - 5mm recession defects .