脱细胞真皮基质在牙龈退缩治疗中的应用评价

Experimental evaluation of acellular dermal matrix for the treatment of gingival recessions

目的评价脱细胞真皮基质(acellular dermal matrix,ADM)代替上皮下结缔组织瓣在Ⅰ类牙龈退缩治疗中的应用效果。方法在犬尖牙上制造Ⅰ类牙龈退缩模型,实验组用ADM加冠向复位瓣治疗,对照组用单纯冠向复位瓣治疗。观察和测量比较基线和术后8周时牙龈退缩高度、临床附着水平、角化龈的宽度和厚度等。结果术后8周,实验组治疗牙龈退缩的根面覆盖率为52.53%,明显高于对照组的15.89%,差异有高度显著性(P<0.01);实验组的角化龈宽度和高度比基线时分别增加1.06mm和0.18mm,而对照组则比基线时分别减少1.19mm和0.27mm,两者比较,差异也有高度显著性(P<0.01)。结论 ADM代替上皮下结缔组织瓣治疗Ⅰ类牙龈退缩,能比单纯冠向复位瓣获得更高的根面覆盖率,并显著增加角化龈的宽度和厚度。

Objective To evaluate the results of acellular dermal matrix（ADM）as a subepithelial graft in the treatment of Miller class Ⅰ gingival recessions. Methods Miller class Ⅰ gingival recessions were surgically created on the buccal surfaces of all canines in dogs, and ramdonly assigned to： ADM＋（coronally positioned flap）CPF（test group）or CPF alone（control group）. The following measurements were evaluated at baseline and 8 weeks postsurgically： height of recession, clinical attachment level, width of keratinized gingiva and thickness of keratinized gingiva. Results At 8 weeks,the mean percent of root coverage were 52.53% and 15.89% for the test and control groups, respectively. The former showed a statistically significantly better results than the latter（P〈0.01）. In addition, in the test group the width and thickness of keratinized gingiva increased 1.06 mm and 0.18 mm, respectively, while in the control group, the width and thickness of keratinized gingival decreased 1.19 mm and 0.27 mm, respectively. There was statistically significant differences between the groups（P〈0.01）. Conclusion ADM provided significantly higher root coverage, and resulted in a greater increase in the width and thickness of keratinized gingiva in treating Miller class Ⅰgingival recession than CPF alone.