A multicenter randomized, controlled clinical trial comparing the use of displacement cords, an aluminum chloride paste, and a combination of paste and cords for tissue displacement
A multicenter randomized, controlled clinical trial comparing the use of displacement cords, an aluminum chloride paste, and a combination of paste and cords for tissue displacement
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DOI：
10.1016/j.prosdent.2017.03.010
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发表时间：
2018-01-01
影响因子：
4.6
通讯作者：
Pjetursson, Bjarni E.
中科院分区：
文献类型：
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作者：
Einarsdottir, Erna R.;Lang, Niklaus P.;Pjetursson, Bjarni E.
问题陈述。固定修复中用于印模的软组织移位后的牙龈退缩可能会给口腔美学区域的治疗成功带来问题。对常见牙龈移位方法的软组织反应的了解有限。目的。这项临床随机对照试验 (RCT) 的目的是评估使用 3 种不同的牙龈组织移位技术对天然牙齿进行确定印模时边缘软组织高度的变化。材料和方法。总共 67 名个体被随机分为 3 组。在测试组1（P；n=22）中，仅使用氯化铝糊剂来置换牙龈。在测试组2（CP；n=23）中，插入绳索，并且还使用氯化铝糊剂。在对照组（C；n=22）中，使用 2 根绳索移位牙龈（双绳技术）。在治疗开始前和修复体交付后 30 至 10 天进行牙龈位置的临床测量。在治疗的不同阶段制作研究模型，制作标准化照片，并使用图形编辑软件测量颊侧牙龈位置的变化。此外，还记录了参与者对临床程序的看法以及技术人员对模具准备的评估。应用单向方差分析模型来比较各组之间的响应变量：（a）牙龈边缘的位置（毫米），（b）平均探诊深度（毫米），（c）牙龈厚度（毫米），（d）角化组织的量（毫米）和（e）牙龈边缘高度的平均变化（毫米）。未配对的 t 检验也用于比较组间的平均值。为了比较不同类别之间的情况，进行了卡方检验（所有检验的 alpha=0.05）。结果。在印模和分娩之间的期间，P 牙龈高度小幅增加 0.058 毫米（+/- 0.13 SD），CP 牙龈高度小幅增加 0.013 毫米（+/- 1.19 SD）。然而，C 组报告了 0.049 毫米（+/- 0.13 SD）的轻微牙龈退缩。所有组的结果显示，21% 的基牙牙龈高度增加 > 0.1 毫米，58% 的牙龈高度稳定（0 +/- 0.10 毫米），21% 表现出轻微的牙龈退缩（0.1 至 0.5 毫米），并且没有基牙出现中度或重度退缩。牙龈退缩（>0.5 毫米）。 P组轻微牙龈退缩的发生率为8%，CP组为23%，C组为32%（P=0.015）。十五名参与者（24%）在手术后感到一些不适。组间差异不显着（P>.05）。实验室技术人员发现，P 组（视觉模拟量表 [VAS]，79）和 CP（VAS，82）的最终模具制备比 C 组（平均 VAS，93；P=.003）更具挑战性。结论。轻微或中度牙龈退缩（
Statement of problem. Gingival recession after soft tissue displacement for impression making in fixed prosthodontics may pose a problem for treatment success in the esthetic areas of the mouth. Knowledge about the soft tissue reaction of common gingival displacement methods is limited.Purpose. The purpose of this clinical randomized controlled trial (RCT) was to evaluate changes in the marginal soft tissue height with 3 different gingival tissue displacement techniques for definitive impression making of natural teeth.Material and methods. A total of 67 individuals were randomized to 3 groups. In test group 1 (P; n=22), only aluminum chloride paste was used to displace the gingiva. In test group 2 (CP; n=23), a cord was inserted, and aluminum chloride paste was also used. In the control group (C; n=22), 2 cords were used to displace the gingiva (double-cord technique). Clinical measurements of the gingival position were made before treatment began and at 30 10 days after prosthesis delivery. Study casts were fabricated at different stages of the treatment, standardized photographs were made, and changes in the buccal gingival position were measured using graphics editing software. In addition, the participants' perception of the clinical procedure and the technicians' evaluation of the die preparation were recorded. One-way ANOVA models were applied to compare the response variables among the groups: (a) the position of the gingival margin (millimeters), (b) mean probing pocket depth (millimeters), (c) gingival thickness (millimeters), (d) amount of keratinized tissue (millimeters), and (e) mean changes in gingival margin height (millimeters). Unpaired t tests were also used to compare the mean values between groups. For comparisons between different categories, chi-square tests were performed (alpha=.05 for all tests).Results. In the period between impression and delivery, a minor gain in gingival height of 0.058 mm (+/- 0.13 SD) for P and 0.013 mm (+/- 1.19 SD) for CP. However, a minor gingival recession of 0.049 mm (+/- 0.13 SD) was reported for group C. The results for all groups showed that 21% of abutment teeth gained >0.1 mm in gingival height, 58% had stable gingival height (0 +/- 0.10 mm), 21% showed minor gingival recession (0.1 to 0.5 mm), and no abutment teeth showed moderate or severe gingival recession (>0.5 mm). The incidence of minor gingival recession was 8% in group P, 23% in group CP, and 32% in group C (P=.015). Fifteen participants (24%) experienced some discomfort after the procedure. The differences between the groups were not significant (P>.05). The laboratory technicians found the definitive die preparation significantly more challenging for group P (visual analog scale [VAS], 79) and CP (VAS, 82) than group C (mean VAS, 93; P=.003).Conclusions. Minor or moderate gingival recession (