歯肉退縮の治療における冠状動脈前進フラップおよび結合組織移植片と、成長因子を豊富に含む血漿（PRGF）の併用または非併用

Coronally advanced flap and connective tissue graft with or without plasma rich in growth factors (PRGF) in treatment of gingival recession.

抄録

背景:

歯肉退縮の治療法を改善しようとする研究者が何人かいる。本研究は、MillerクラスI頬側歯肉退縮の治療におけるCAF（coronally advanced flap）＋CTG（結合組織移植片）＋PRGF（plasma rich in growth factors）の効果を評価するために行われた。

BACKGROUND: Several researchers have tried to improve the results of gingival recession treatment techniques. One of the methods is to use growth factors The present study was undertaken to evaluate the effect of CAF (coronally advanced flap) + CTG (connective tissue graft) + PRGF (plasma rich in growth factors) in the treatment of Miller Class I buccal gingival recession.

材料と方法:

26～47歳の患者6名のMiller Class Iの歯肉退縮を有する22歯を対象とし、分割口をデザインした無作為化比較試験(RCT)を行った。各患者において、片側をCAF＋CTG＋PRGF（試験）、もう片側をCAF＋CTG（対照）で治療した。角化組織幅（KTW）、臨床的アタッチメントレベル（CAL）、プロービングデプス（PD）、垂直退縮深度（VRD）、退縮深度（RD）、歯肉厚（GT）、根面被覆率（RC％）、CEJと粘膜歯肉接合部間の距離（MGJL）。データは、paired t-testおよび反復測定ANOVAを用いて分析した。

MATERIAL AND METHODS: Twenty-two teeth with Miller Class I gingival recession in 6 patients 26 ‒ 47 years of age were included in a split-mouth designed randomized controlled trial (RCT). In each patient, one side was treated with CAF + CTG + PRGF (test) and the other side was treated with CAF + CTG (control). The following parameters were measured before surgery and up to 6 months after surgery on the mid-buccal surface of the tooth: keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), vertical recession depth (VRD), recession depth (RD), gingival thickness (GT), root coverage in percentage (RC%) and the distance between the CEJ and mucogingival junction (MGJL). Data were analyzed with paired t-test and repeated measures ANOVA.

結果:

6ヵ月後、PDを除くすべての測定変数において、両群で顕著な改善が観察されたが、両群間の差は有意ではなかった。6ヵ月後のRC％は、試験群で80±25％、対照群で67±28％であった。

RESULTS: After 6 months noticeable improvements were observed in both groups in all the variables measured except for PD; however, the differences between the two groups were not significant. RC% was 80 ± 25% and 67 ± 28% in the test and control groups, respectively, after 6 months.

結論:

CAF＋CTG＋PRGFおよびCAF＋CTGの両治療法は、良好な歯根被覆をもたらしたが、PRGFの添加は測定可能な有意な効果をもたらさなかった。結合組織移植、歯根被覆、歯肉退縮、成長因子、粘膜歯肉外科、歯周形成外科。

CONCLUSIONS: Both CAF + CTG + PRGF and CAF + CTG treatment modalities resulted in favorable root coverage; however, the addition of PRGF added no measurable significant effect. Connective tissue graft, dental root coverage, gingival recession, growth factors, mucogingival surgery, periodontal plastic surgery.