Root coverage using a coronally advanced flap with or without acellular dermal matrix: a meta-analysis
Root coverage using a coronally advanced flap with or without acellular dermal matrix: a meta-analysis
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使用带或不带脱细胞真皮基质的冠状先进瓣进行根部覆盖：荟萃分析
DOI：
10.5051/jpis.2016.46.1.22
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发表时间：
2016-02-01
影响因子：
1.9
通讯作者：
Cao, Zhengguo
中科院分区：
文献类型：
--
作者：
Guan, Wei;Liao, Haiqing;Cao, Zhengguo
目的牙龈退缩是一个主要的美学问题，并可能导致根管敏感在牙周治疗。带或不带脱细胞真皮基质（ADM）的冠状推进皮瓣（CAF）广泛用于根面覆盖手术。本研究的目的是分析CAF联合ADM治疗牙龈退缩的疗效。方法检索PubMed、科克伦图书馆、Embase等相关文献。筛选文章，提取数据，并由三名具有临床实践，试验，统计学和生物医学编辑专业知识的评审员评估研究质量。关注的临床终点包括后退、探测深度（PD）、临床附着水平（CAL）和角化组织（KT）的变化。结果共纳入10项随机对照试验，其中6项比较了CAFs联合ADM和CAFs使用结缔组织移植（CTG）的研究，4项比较了CAFs联合或不联合ADM的研究。而ADM和CAF联合组与单纯CAF组之间在以下方面存在统计学显著差异：经济衰退覆盖率、CAL和KT。CAF与ADM同种异体移植物的组合比单独CAF实现了更有利的后退覆盖和CAL和KT的恢复。结论ADM组和CTG组的结果表明，两种手术在临床实践中可能同样有效。鉴于本研究的局限性，需要进一步研究以阐明ADM和CAF在临床实践中的有效性。
Purpose Gingival recession is a major esthetic concern and may lead to root sensitivity during periodontal treatment. Coronally advanced flaps (CAFs) with and without acellular dermal matrix (ADM) are widely used in root coverage procedures. The aim of this study was to analyze the efficacy of CAF in combination with ADM in the treatment of gingival recession. Methods PubMed, The Cochrane Library, and Embase were used to identify relevant articles. The articles were screened, data were extracted, and the quality of the studies was assessed by three reviewers with expertise in clinical practice, trials, statistics, and biomedical editing. The clinical endpoints of interest included changes in recession, probing depth (PD), clinical attachment level (CAL), and keratinized tissue (KT). Results Ten randomized controlled trials were identified, including six studies that compared CAFs with ADM and CAFs using connective tissue grafting (CTG) and four studies that compared CAFs with or without ADM. No statistically significant differences were found between the use of ADM and CTG, whereas statistically significant differences were found between groups in which ADM and CAF were combined and groups that underwent CAF alone with regard to recession coverage, CAL, and KT. The combination of CAF with an ADM allograft achieved more favorable recession coverage and recovery of CAL and KT than CAF alone. Conclusions The results from the ADM and CTG groups suggest that both procedures may be equally effective in clinical practice. Given the limitations of this study, further investigation is needed to clarify the effectiveness of ADM and CAF in clinical practice.