Dantenų recesijos chirurginio gydymo metodų palyginimas, taikant vainiko link paslinkto lopo operaciją: literatūros sisteminė apžvalga

Abstract

Dantenų recesija - būklė, kai dantenos juda danties šaknies viršūnės link ir atsitraukia nuo cemento emalio jungties (CEJ) apnuogindamos šaknies paviršių. Recesijų gydymas yra reikalingas, nes apnuoginti šaknų paviršiai gali būti jautrūs, yra lengvai pažeidžiami dantų ėduonies ir sukelti estetinių problemų. Recesijų gydymui yra taikomos chirurginės procedūros - vainiko link paslinkto lopo operacija, kurios metu taip pat gali būti taikomas subepitelinio jungiamojo audinio transplantato iš gomurio persodinimas ar nukreipiamosios audinių regeneracijos metodikos - trombocitų gausaus fibrino, emalio matricos derivato, kolageninių matricų ar beląstelinės dermos matricos alotransplantato. Gingival recession is defined as an apical displacement of the free gingival margin from the cemento-enamel (CEJ) junction. It might be caused by orthodontic treatment, incorrect teeth brushing technique etc. The treatment of gingival recession is requisite, becaused exposed root surfaces can be sensitive, cause aesthetic problems etc. Aim: The aim of this study was to compare several different surgery techniques used for gingival recession treatment, such as coronally advanced flap (CAF) or CAF used together with subepithelial connective tissue graft (SCTG) or guided tissue regeneration (GTR) techniques. Materials and methods: randomized clinical trials, clinical trials, pilot studies on treatment of Miller Class I and II gingival recessions with at least 6 months of follow-up were identified. Data sources included electronic databases (Science Direct, Pubmed – Medline, Cohrane Library CENTRAL) and paper journals. The main outcome variable was gingival recession deep and apico-coronal height of keratinized tissue before surgery and the results after 6 months of follow-up. Results. A total of 185 patients from 5 selected articles were evaluated in this systematic review. CAF and collagen matrix graft (CM) or CAF and SCTG techniques were associated with supreme recession reduction and gain of keratinized tissue, which was statistically significant. The least effective technique, according to the evaluated articles, was the CAF technique. Conclusions. Further efficacy studies should be carried out with more periodontal measurements of these procedures. According to the evaluated articles, combined CAF and CM or CAF and SCTG techniques can be considered to be the most efficient.