用特定部位的双层透明真皮基质或结缔组织移植包膜冠状先进皮瓣治疗多发性边缘组织凹陷：病例回顾性分析。

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics Pub Date : 2023-02-24 DOI:10.1002/cap.10240

Saravanan Sampoornam Pape Reddy, Shreehari Ambika Krishnan, Sangeeta Singh, Krishnaprasad Kondajji Ramachandra, Harjeet Singh, Ruchi Harish, Delfin Lovelina Francis

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引用次数: 0

摘要

背景：采用传统或双层方法治疗多发性边缘组织凹陷（MTR）时，正确的病例选择和决策至关重要。冠状前移皮瓣（CAF）是治疗多发性边缘组织凹陷的常用方法之一。CAF与软组织移植相结合，作为双层技术，在牙根覆盖方面取得了显著的成功：本病例系列旨在回顾性评估 Zucchelli 的改良包膜 CAF（eCAF）以及使用细胞真皮基质（ADM）和结缔组织移植（CTG）治疗 MTR 的特定部位双层法。我们对采用三种不同技术治疗的 15 例患者（每种技术治疗 5 例患者/25 个部位，总部位数 = 75 个）的术后 12 个月记录进行了回顾性评估。与基线相比，所有患者的牙根覆盖率都有明显的临床改善。术后 3 个月（90%）、6 个月（95%）和 12 个月（95%）的平均牙根覆盖率在三种方法之间没有明显差异。86.6%的 eCAF 病例以及 86.6% 和 95% 的 ADM/CTG 和 eCAF 病例都观察到了完全的牙根覆盖。所有组别中，角化组织的宽度都有所增加：临床结果表明，只有在特殊情况下才能使用双层技术。结论：临床结果表明，只有在特定病例中才应使用双层技术，如果能根据每个病例的具体情况制定谨慎的技术选择治疗方案，就可以在不使用软组织移植或替代物的情况下获得可预测的效果：为什么本病例是新信息？特定部位双层皮瓣模式与单纯改良冠状皮瓣的比较成功处理此类病例的关键是什么？皮瓣推进和移动皮瓣被动性此类病例成功的主要限制因素是什么？病例选择皮瓣张力软组织表型移植物厚度操作者技能。

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Envelope coronally advanced flap with site-specific bilaminar acellular dermal matrix or connective tissue graft for management of multiple marginal tissue recessions: A retrospective analysis of cases

Background

A proper case selection and decision making is essential for management of multiple marginal tissue recessions (MTR) using a conventional or bilaminar approach. Coronally advanced flap (CAF) is one of the commonly used methods for management of MTR. CAF has been advocated in combination with soft tissue grafts as bilaminar technique, which had showed significant success in terms of root coverage.

Methods and Results

Aim of this case series was to retrospectively evaluate Zucchelli's modification of envelope CAF (eCAF) and site-specific bilaminar methods using Acellular Dermal Matrix (ADM) and Connective Tissue Graft (CTG) for management of MTR. A total of 15 subjects (five subjects/25 sites per technique, total number of sites = 75) who were managed by three different techniques with 12 months postoperative records were retrospectively evaluated. All patients showed significant clinical improvement in root coverage outcomes when compared to baseline. Mean root coverage achieved at 3 months (90%), 6 months (95%) and 12 months (95%) postoperatively did not reveal significant difference between three methods. Complete root coverage was observed in 86.6% of eCAF cases and in 86.6% and 95% of ADM/CTG with eCAF, respectively. There was an increase in width of keratinised tissue, both individually and collectively across all of the groups.

Conclusion

Clinical outcomes suggested that bilaminar techniques should be used only in specific cases. Predictable results can be obtained without the use of a soft tissue graft or substitute if a careful treatment plan for technique selection is developed on an individual case-by-case basis.