Dişeti çekilmesi tedavisinde kullanılan farklı materyallerin klinik sonuçlarının değerlendirilmesi
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Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çoklu dişeti çekilmelerinin tedavisinde hayvan kaynaklı aselüler dermal matrix
(XADM) veya bağ dokusu grefti (Bdg) ile kombine modifiye koronale kaydırılan flep ile
tedavisinin klinik etkinliğinin değerlendirilmesi.
Gereç ve Yöntem: İki taraflı çoklu dişeti çekilmesi bulunan 12 katılımcıya, aynı seansta
randomize seçilmiş bir tarafına ksenojenik asellular dermal matrix (test grubu, 41 diş) ile
diğer tarafına ise bağ dokususu (kontrol grubu, 41 diş) ile birlikte M-CAF uygulaması 18
aylık çalışma sürecinde tamamlandı. Başlangıç ile operasyon sonrası 6. ve 18. aylarda
çekilme derinliği (ÇD), çekilme genişliği (ÇG), keratinize doku genişliği (KDG),
sondalama derinliği (SD) ve klinik ataşman seviyesi (KAS) kaydedildi.
Bulgular: Sondalama derinliği 18. ayda test grubunda anlamlı olarak daha yüksektir.
(p<0.05) Test grubunda sondalama derinlikleri 6. ve 18. Aylarda başlangıçla
kıyaslandığında anlamlı olarak yüksetir. (p<0.05) Her iki grupta da çekilme derinlikleri
ve çekilme genişlikleri 6. ve 18. aylarda başlangıçla kıyaslandığında anlamlı olarak
düşüktür (p<0.05) ve her iki parametre 18. ayda test grubunda anlamlı olarak daha
yüksektir. Kök kapaması gerçekleştirilen dişlerin yüzdesi test ve kontrol gruplarında
6.(sırayla %78 ve %70,7) ve 18. Aylarda (her ikisi de %87,8) benzer bulunmuştur.
Sonuç: Çalışmanın sınırlamaları dahilinde Miller Sınıf 1 ve 2 çoklu dişeti çekilmelerinin çekilme
derinliğinde azalma MCAF ile kombine XADM ve BDG gruplarının kısa dönem
sonuçları benzerlik göstermiştir. 18 aylık takipte BDG uygulanan grupta daha stabil klinik
sonuçlar gözlenirken; XADM uygulanan grupta yumuşak doku büzülmesi ve sondalama
derinliğinde artış gözlemlenebilir.
Objective: To evaluate the clinical efficacy of xenogeneic acellular dermal matrix (XADM) or connective tissue graft (CTG) combined with modified-coronally advanced flap (MCAF) in the treatment of multiple gingival recessions. Materials and Methods: Twelve participants with bilateral MGRs (82 gingival recessions) randomly received XADM (test group, 41 teeth) on one side and subepithelial CTG (control group, 41 teeth) on the other side in conjunction with MCAF in the same session and completed the 18-months study period. Recession depth (RD), recession width (RW), keratinized tissue width (KTW), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, and 6-, 18-months postoperatively. Results: PD was significantly higher in the test group at 18-months (p<0.05). PD in the test group was also significantly higher at 6- and 18-months compared to baseline (p<0.05). RD and RW were significantly lower at 6- and 18-months compared to baseline in both groups (p<0.05) and both parameters were significantly higher in the test group at 18-months (p<0.05). Percentage of teeth with complete root coverage in the test and control groups were similar at 6-months (78% and 70.7%, respectively) and at 18-months (both 87.8%) (p>0.05). Conclusion: Within the limits of the study, M-CAF combined with XADM or CTG seems to be similarly effective in RD reduction of Class I and II MGRs at least in the short term. Soft tissue shrinkage and increase in PD may be observed with XADM, while; CTG seems to provide stable clinical outcomes for 18-months follow-up.
Objective: To evaluate the clinical efficacy of xenogeneic acellular dermal matrix (XADM) or connective tissue graft (CTG) combined with modified-coronally advanced flap (MCAF) in the treatment of multiple gingival recessions. Materials and Methods: Twelve participants with bilateral MGRs (82 gingival recessions) randomly received XADM (test group, 41 teeth) on one side and subepithelial CTG (control group, 41 teeth) on the other side in conjunction with MCAF in the same session and completed the 18-months study period. Recession depth (RD), recession width (RW), keratinized tissue width (KTW), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, and 6-, 18-months postoperatively. Results: PD was significantly higher in the test group at 18-months (p<0.05). PD in the test group was also significantly higher at 6- and 18-months compared to baseline (p<0.05). RD and RW were significantly lower at 6- and 18-months compared to baseline in both groups (p<0.05) and both parameters were significantly higher in the test group at 18-months (p<0.05). Percentage of teeth with complete root coverage in the test and control groups were similar at 6-months (78% and 70.7%, respectively) and at 18-months (both 87.8%) (p>0.05). Conclusion: Within the limits of the study, M-CAF combined with XADM or CTG seems to be similarly effective in RD reduction of Class I and II MGRs at least in the short term. Soft tissue shrinkage and increase in PD may be observed with XADM, while; CTG seems to provide stable clinical outcomes for 18-months follow-up.
Açıklama
Anahtar Kelimeler
Multiple Gingival Recessions, Xenogeneic Acellular Dermal Matrix, Connective Tissue Graft, Modified-Coronally Advanced Flap
