臼歯部における根面被覆：比較対照無作為化臨床試験

Root coverage in molar teeth: a comparative controlled randomized clinical trial.

抄録

目的:

臼歯部の単発性歯肉退縮に対する LMCAF と BT の臨床成績を比較検討する。

AIM: To compare the clinical outcomes of laterally moved, coronally advanced flap (LMCAF) versus Bilaminar technique (BT) in the treatment of single gingival recession on molar teeth.

材料と方法:

第一大臼歯のミラーIおよびII歯肉退縮を示す50名の患者を治療した。25名がBT群に、25名がLMCAF群に無作為に割り付けられた。術後1週間後に術後経過を、1年後に審美的評価と臨床的評価を行った。

MATERIAL AND METHODS: Fifty patients showing Miller I and II gingival recessions at first molar teeth were treated: 25 were randomly assigned to the BT group and 25 belonged to the LMCAF group. Patient's post-operative morbidity was assessed 1 week after the surgery, while aesthetic evaluation and the clinical evaluation were made 1 year later.

結果:

後退とPPD減少の点では、統計的に有意な差は示されなかった。BT群では、完全歯根被覆率（CRC、オッズ比22.1）および歯肉厚の増加率が統計学的に高かった。LMCAFでは、角化組織の増加がより大きかった。審美性に対する患者満足度は両治療群とも非常に高かった。LMCAFでは術後経過が良好であり，BTでは術後の感度と歯根被覆率の評価が良好であった．

RESULTS: No statistically significant difference was demonstrated in terms of recession and PPD reduction. Statistically greater probability of complete root coverage (CRC, Odds Ratio 22.1) and greater increase in gingival thickness were observed in the BT group. Greater increase in keratinized tissue was obtained in the LMCAF. Patient satisfaction with aesthetics was very high in both treatment groups. Better post-operative course was observed in the LMCAF, while better post-operative sensitivity and root coverage evaluation were demonstrated in patients treated with BT.

結論:

第一大臼歯の歯肉退縮はLMCAFとBTでうまく治療することができる。BTではCRCが良好であり，LMCAFでは術後の経過がより快適であった．

CONCLUSIONS: Gingival recession at first molar teeth can be successfully treated with LMCAF and BT. Better CRC was achieved with BT, while more comfortable post-operative course was associated with the LMCAF.