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。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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