Tunnel technique and subepithelial connective tissue graft, with or without cross-linked hyaluronic acid, in the treatment of multiple gingival recessions: 12-month outcomes of a randomized clinical trial.

IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of periodontology Pub Date : 2024-05-29 DOI:10.1002/JPER.24-0093
Izabela Skierska, Bartłomiej Górski, Łukasz Fus
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Abstract

Background: This study evaluated the influence of the adjunctive application of a cross-linked hyaluronic acid (HA) in the treatment of multiple gingival recessions, using a modified coronally advanced tunnel (MCAT) technique and subepithelial connective tissue graft (SCTG) (MCAT+SCTG±HA).

Methods: A randomized, split-mouth, double-masked comparison of the effects of MCAT+HA+SCTG (test) versus MCAT+SCTG (control) in the treatment of multiple, contralateral gingival recessions with clinical, esthetic, and histological evaluations was carried out. All samples were stained with hematoxylin and eosin, Masson's trichrome, Verhoeff-Van Gieson, and Alcian blue stain for semiquantitative evaluation. The primary outcome variable was 12-month mean root coverage (MRC).

Results: Twenty-four patients with 266 gingival recessions received both control and test treatments (133 recessions per group). 12-month MRC of the MCAT+HA+SCTG group was not significantly different from the MCAT+SCTG group with 84.32%±  34.46% and 85.71%±  36.43%, respectively (p = 0.991). Both treatment modes produced favorable esthetic outcomes (root coverage esthetic score [RES] 9.51±  1.01 tests vs. 9.26±  1.10 controls, p = 0.7292). However, the application of HA improved soft tissue texture (p = 0.0091). The remaining end point measures did not differ significantly between groups. Histological evaluation showed a significantly greater number of elastic fibers and a moderate increase in collagen fiber density in biopsy samples taken from the test sides when compared to the control sides (p = 0.0419 and p = 0.300, respectively).

Conclusions: MCAT+SCTG is an effective procedure in the treatment of multiple recession Type 1 (RT1) and RT2 recessions. There were no statistically significant differences in evaluated clinical treatment outcomes in the MCAT+HA+SCTG group compared to the MCAT+SCTG group within a period of 12 months. The application of HA increased collagen and elastic fiber density.

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隧道技术和上皮下结缔组织移植(含或不含交联透明质酸)治疗多发性牙龈凹陷:随机临床试验的 12 个月结果。
背景:本研究评估了交联透明质酸(HA)辅助应用在治疗多发性牙龈凹陷中的影响,采用的是改良冠状前进隧道(MCAT)技术和上皮下结缔组织移植(SCTG)(MCAT+SCTG±HA):对 MCAT+HA+SCTG(试验)与 MCAT+SCTG(对照)治疗多发性对侧牙龈凹陷的效果进行了随机、分口、双掩蔽比较,并进行了临床、美学和组织学评估。所有样本均采用苏木精和伊红、马森三色染色、Verhoeff-Van Gieson 和阿尔新蓝染色进行半定量评估。主要结果变量是 12 个月的平均牙根覆盖率(MRC):24 名牙龈凹陷患者共 266 个牙龈凹陷,分别接受了对照组和测试组的治疗(每组 133 个凹陷)。MCAT+HA+SCTG组的12个月平均根面覆盖率为84.32%± 34.46%,MCAT+HA+SCTG组为85.71%± 36.43%,与MCAT+SCTG组无明显差异(p = 0.991)。两种治疗模式都产生了良好的美学效果(根覆盖美学评分 [RES] 9.51±1.01 试验组 vs. 9.26±1.10 对照组,p = 0.7292)。不过,HA 的应用改善了软组织质地(p = 0.0091)。其余终点指标在组间无明显差异。组织学评估显示,与对照组相比,试验侧活检样本中弹性纤维数量明显增加,胶原纤维密度适度增加(分别为 p = 0.0419 和 p = 0.300):结论:MCAT+SCTG 是治疗多发性 1 型(RT1)和 RT2 型凹陷的有效方法。与 MCAT+SCTG 组相比,MCAT+HA+SCTG 组在 12 个月内的临床治疗效果评估差异无统计学意义。应用 HA 增加了胶原蛋白和弹性纤维密度。
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来源期刊
Journal of periodontology
Journal of periodontology 医学-牙科与口腔外科
CiteScore
9.10
自引率
7.00%
发文量
290
审稿时长
3-8 weeks
期刊介绍: The Journal of Periodontology publishes articles relevant to the science and practice of periodontics and related areas.
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