富血小板纤维蛋白膜治疗MillerⅢ类牙龈退缩的疗效分析

The Effect Analysis in the Treatment of MillerⅢGingival Recession Using Platelet Rich Fibrin Membranes(PRF)

目的:评估改良冠向复位瓣术(MCAF)联合富血小板纤维蛋白膜(PRF)或上皮下结缔组织移植物(SCTG)在MillerⅢ类牙龈退缩治疗中的临床效果。方法:选择符合MillerⅢ类牙龈退缩诊断标准的12例患者,随机分为实验组(MCAF+PRF)和对照组(MCAF+SCTG),其中6例15颗患牙纳入实验组(PRF组),6例15颗牙纳入对照组(SCTG组)。在术前(基线)及术后8月测量并记录牙龈退缩的量(RD)、牙周探诊深度(PD)、角化龈宽度(KTW)等指标。结果:两组间术前PD、RD、KTW无统计学差异(P>0.05),两组术后8个月RD和KTW较术前均有所改善(P<0.05);两组间术后PD、RD无统计学差异(P>0.05),但平均根面覆盖率实验组(57±20)%,小于对照组的(72±21)%。结论:MCAF+PRF治疗MillerⅢ类牙龈退缩的根面覆盖率虽不及MCAF+SCTG,但同样可以获得良好的根面覆盖效果,改善临床症状;同时,由于PRF的应用,避免了第二术区,减少术后不适感,具有一定临床推广价值。

Objective To evaluate the clinical effect of modified coronally advanced flap(MCAF)combined with platelet rich fibrin membrane(PRF)or subepithelial connective tissue grafts(SCTG)in the treatment of Miller III gingival recession.Methods 12 patients who met the criteria of Miller III gingival recession were randomly divided into test group(MCAF+PRF)and control group(MCAF+SCTG).Among them,15 teeth from 6 patients were included in the test group(PRF group)and 15 teeth from 6 patients were included in the control group(SCTG group).The gingival recession depth(RD),probing depth(PD)and keratinized tissue width(KTW)were measured and recorded before and 8 months after operation.Results There was no significant difference in baseline PD,RD and KTW between the two groups(P>0.05),and the RD and KTW of the two groups were improved 8 months after operation(P<0.05);there was no significant difference in postoperative PD and RD between the two groups(P>0.05),but the mean root coverage of the test group was(57±20)%less than that of the control group(72±21)%.Conclusion Although the root coverage rate of MillerⅢgingival recession treated with MCAF+PRF is lower than that of MCAF+SCTG,it can also obtain good root coverage effect,and improve clinical symptoms;in addition,due to the application of PRF,the second operation area is avoided,and the postoperative discomfort is reduced,which has a certain clinical promotion value.