改良隧道技术联合树脂充填治疗伴非龋性牙颈部缺损的多牙位牙龈退缩的效果分析

Efficacy of modified coronally advanced tunnel technique combined with resin restoration for the treatment of multiple gingival recession with non-carious cervical lesions

目的·观察改良隧道技术(modified coronally advanced tunnel technique,MCAT)结合树脂充填治疗伴非龋性牙颈部病变(non-carious cervical lesion,NCCL)的多牙位牙龈退缩临床效果。方法·纳入伴NCCL的多牙位牙龈退缩的患者,通过树脂充填结合MCAT+上皮下结缔组织移植物(subepithelial connective tissue graft,sCTG)技术修复患牙冠根部的软硬组织缺损。在术前及术后6个月随访时检查患牙的探诊深度(probing depth,PD)、出血指数(bleeding index,BI)、菌斑指数(plaque index,PLI)、牙龈退缩高度(recession height,RH)、角化龈宽度(keratinized tissue width,KTW)、牙龈厚度(gingival thickness,GT)、龈乳头高度,并行根面覆盖美学评分(root coverage esthetic score,RES)。结果·共纳入3名患者,9个牙位。术后6个月时,BI、PLI、RH较术前下降;而KTW、GT及龈乳头高度均较术前增加,龈乳头高度较术前增加了(0.67±0.75) mm,术后RES评分为(8.56±1.33)分。结论·MCAT结合树脂充填技术能有效改善伴NCCL的多牙位牙龈退缩,获得唇颊侧及邻面软组织增量,并取得良好的美学效果。

Objective·To observe the clinical efficacy of modified coronally advanced tunnel technique(MCAT) combined with resin restoration in treating multiple gingival recession with non-carious cervical lesion(NCCL). Methods·Subjects with multiple gingival recession and NCCL were enrolled in the trial. All the patients were treated with MCAT with subepithelial connective tissue graft(sCTG) and resin restoration to repair the soft and hard tissue defect. Probing depth(PD), bleeding index(BI), plaque index,(PLI), recession height(RH), keratinized tissue width(KTW), gingival thickness(GT), and interdental papilla height were measured at baseline and 6-month follow-up. Root coverage esthetic score(RES) was also evaluated 6 months postoperatively. Results·Three patients were treated in this study, including 9 sites. The mean BI, PLI and RH were significantly decreased at 6 months after treatment compared with the baseline. The augment of KTW, GT and interdental papilla height was achieved at follow-up, and interdental papilla height increased by(0.67±0.75) mm compared with the baseline. The mean RES was 8.56±1.33, postoperatively.Conclusion·The MCAT combined with resin restoration could be a promising treatment for multiple gingival recession, resulting in ideal esthetic effect by the augment of buccal and interdental soft tissue.