The coronally advanced flap in combination with platelet-rich fibrin (PRF) and enamel matrix derivative in the treatment of gingival recession: a comparative study.
The coronally advanced flap in combination with platelet-rich fibrin (PRF) and enamel matrix derivative in the treatment of gingival recession: a comparative study.
复制标题
冠状先进皮瓣联合富血小板纤维蛋白（PRF）和牙釉质基质衍生物治疗牙龈退缩：一项比较研究。
DOI：
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
B. Dimitrijević
中科院分区：
文献类型：
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作者：
Sasha Jankovic;Zoran Aleksić;I. Milinković;B. Dimitrijević
目的
本研究的主要目的是评价富含血小板的纤维蛋白膜与冠状推进皮瓣（CAF）联合使用的临床有效性，并将其与釉基质衍生物（EMD）与冠状推进皮瓣联合使用在牙龈退缩治疗中进行比较。
材料和方法
对20例上颌前牙或双尖牙的裂口患者进行了米勒I类或II类牙龈退缩的治疗，分别采用CAF联合富血小板纤维蛋白膜（PRF组）或EMD（EMD组）置于CAF下。在基线和治疗后12个月测量以下参数：牙龈退缩（GR），角化组织的尖冠宽度（WKT）和探测深度（PD）。
结果
PRF组的完全腐烂覆盖率为65%（20次衰退中的13次），EMD组为60%（20次衰退中的12次）。基线时，PRF组和EMD组的GR分别为4.10 ± 1.05 mm和3.90 ± 1.00 mm; 12个月时，PRF组和EMD组的GR分别为1.05 ± 0.45 mm和1.15 ± 0.65 mm。12个月时两组之间观察到的差异具有统计学显著性。EMD组的平均根面覆盖率为70.5%，PRF组为72.1%。基线时EMD组和PRF组的WKT分别为1.30 ± 0.56 mm和1.45 ± 0.86 mm，12个月时EMD组和PRF组的WKT分别为1.90 ± 0.81 mm和1.62 ± 0.28 mm。12个月时两组之间观察到的差异无统计学显著性。两组间PD的两个月变化无显著差异。两组疼痛强度差异有统计学意义。前5天，两组之间的疼痛强度存在统计学差异，有利于PRF组。
结论
目前的研究没有成功地证明使用PRF相比EMD在覆盖CAF手术的牙龈退缩方面的任何临床优势。EMD组在增加WKT方面的成功率高于PRF组。
OBJECTIVE
The main objective of this study was to evaluate the clinical effectiveness of platelet-rich fibrin membrane used in combination with a coronally advanced flap (CAF) and to compare it with the use of an enamel matrix derivative (EMD) in combination with a coronally advanced flap in gingival recession treatment.
MATERIAL AND METHODS
20 split-mouth cases of maxillary anterior teeth or bicuspids presenting with Miller Class I or II gingival recession were treated with a CAF combined with a platelet-rich fibrin membrane (PRF group) or with EMD (EMD group) placed under a CAF. The following parameters were measured at baseline and at 12 months post treatment: gingival recession (GR), apicocoronal width of the keratinized tissue (WKT), and probing depth (PD).
RESULTS
Complete rot coverage in the PRF group was 65% (13 out of 20 recessions) and 60% in the EMD group (12 out of 20 recessions). GR was 4.10 ± 1.05 mm in the PRF group and 3.90 ± 1.00 mm in the EMD group at baseline, and 1.05 ± 0.45 mm in the PRF group and 1.15 ± 0.65 mm in the EMD group at 12 months. The difference observed between the tow groups at 12 months was statistically significant. Average root coverage was 70.5% in the EMD group and 72.1% in the PRF group. WKT was 1.30 ± 0.56 mm in the EMD group and 1.45 ± 0.86 mm in the PRF group at baseline, and 1.90 ± 0.81 mm in the EMD group and 1.62 ± 0.28 mm in the PRF group at 12 months. The difference observed between the two groups at 12 months was not statistically significant. Twelve-month changes in PD were not significantly different between the two groups. The pain intensity was statistically different between the two groups. The pain intensity was statistically different between groups for the first 5 days, favoring the PRF group.
CONCLUSIONS
The present study did not succeed in demonstrating any clinical advantage of the use of PRF compared to EMD in the coverage of gingival recession with the CAF procedure. The EMD group showed a higher success rate in increasing WKT than did the PRF group.