经前庭沟切口的骨膜下隧道技术联合上皮下结缔组织移植术治疗多牙MillerⅠ度牙龈退缩的初步探索(附1例报告)

Preliminary study of the vestibular incision subperiosteal tunnel access combined with subepithelial connective tissue graft in the treatment of multiple adjacent Miller class Ⅰ gingival recession:a case analysis

牙龈退缩作为牙周炎最常见的伴发病变,可导致根面敏感及美学区的粉色美学缺陷,影响患者口腔相关生活质量。如何微创、有效地恢复牙龈形态,改善美观,是医生和患者共同关注的焦点。牙龈冠向复位瓣(CAF)结合上皮下结缔组织移植术(SCTG)可较好地改善牙龈退缩、覆盖裸露根面,是临床公认的有效治疗手段。近年来提出的一种经前庭沟切口的骨膜下隧道技术(VISTA),与SCTG联合应用,在有效覆盖根面的同时,可减少术区范围及术后疼痛等并发症的发生。文章展示了1例尖牙及前磨牙区域多牙MillerⅠ度牙龈退缩病例的临床处置过程,详细介绍了VISTA与SCTG联合应用解决牙龈退缩并获得完全根面覆盖效果的操作流程与技术要点,经过19~20个月的观察,临床效果保持稳定。

As one of the most common lesions associated with periodontitis,gingival recession may result in the exposure of root surfaces leading to tooth hypersensitivity and esthetic deficiencies,which impairs patients′ oral health-related quality of life. Thus,requirements have been raising for a minimally invasive,effective treatment approach to improving the gingival contour and esthetics. It is well recognized that the subepithelial connective tissue graft(SCTG)combined with coronally advanced flap(CAF)are effective root coverage procedures with high predictability. In recent years,the combination of vestibular incision subperiosteal tunnel access(VISTA)and SCTG has been used,which can achieve satisfactory outcomes of root coverage and decrease the incidence of post-surgical morbidities. This paper illustrates a case of multiple adjacent Miller class I gingival recession in canines and premolars treated with the combination of VISTA with SCTG to achieve complete root coverage and the rehabilitation of esthetics. The satisfactory and stable clinical results were successfully kept during the 19~20 months of follow-up period.