树脂充填结合多牙位冠向复位瓣技术治疗非龋性牙颈部病变合并牙龈退缩的临床疗效

Long-term clinical outcome of the resin restoration plus multiple coronally advanced flap technique for the treatment of gingival recession associated with non-carious cervicallesion

目的观察树脂充填结合多牙位冠向复位瓣技术(multiple coronally advanced flap,MCAF)治疗伴非龋性牙颈部病变(noncarious cervical lesion,NCCL)合并牙龈退缩的临床疗效.方法选取伴NCCL的多牙位牙龈退缩患者3例,使用树脂充填+MCAF,并结合上皮下结缔组织移植术(subepthelial connective tissue graft,SCTG)进行缺损区域软硬组织的修复.术后随访3年,比较手术前后的探诊深度(probing depth,PD)、出血指数(bleeding index,BI)、菌斑指数(plaque index,PLI)、退缩高度(recession height,RH)、角化龈宽度(keratinized tissue width,KTW)、牙龈厚度(gingiva thickness,GT),并计算根面覆盖美学评分(root coverage esthetic score,RES)评价术后长期随访的美学效果.结果本研究共纳入3例患者,共10个位点.PD由(1.10±0.32)mm至(1.65±0.34)mm,P=0.001;BI由0.10±0.32至0.50±0.53,P=0.037;PLI由0.30±0.48至0.40±0.52,P=0.660;10个位点均获得了100%的根面覆盖率和角化龈宽度、牙龈厚度的增加,P值分别为<0.000、0.003、<0.000.术后3年随访的RES为(9.40±0.95)分.结论树脂充填结合MCAF+SCTG技术可以修复NCCL造成的牙颈部硬组织缺损和牙龈软组织缺损,美学效果良好.

Objective To observe the long-term clinical outcome of the resin restoration plus multiple coronally advanced flap technique(MCAF)for the treatment of gingival recession associated with non-carious cervical lesion(NCCL).Methods Three patients with multiple gingiva recession with NCCL were selected,and the resin restoration+MCAF combined with subepithelial connective tissue graft(SCTG)was performed to repair the soft and hard tissue'defects.Pocket depth(PD),bleeding index(BI),plaque index(PLI),recession height(RD),keratinized tissue width(KTW)and gingiva thickness(GT)were measured at baseline and follow-up 3-year after treatment and the root coverage esthetic score(RES)was calculated.Results Totally 3 patients and 10 sites were treated.The mean PD at baseline and follow-up were(1.10±0.32)mm and(1.65±0.34)mm,P=0.001.The mean BI at baseline and followup were(0.10±0.32)and(0.50±0.53)mm,P=0.037.The mean PLI at baseline and follow-up were(0.30±0.48)mm and(0.40±0.52)mm,P=0.660.All sites achieved 100%root coverage and significant augmentation of KTW and GT,and the P value was<0.000,0.003 and<0.000.The mean RES at 3-year follow-up was 9;40±0.95.Conclusion The resin restoration plus MCAF could efficiently repair the soft and hard tissue defects caused by NCCLs,and present a great esthetic outcome.