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Informationen aus Orthodontie & Kieferorthopädie 2011; 43(04): 285-294
DOI: 10.1055/s-0031-1301065
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Behandlung von multiplen Gingivarezessionen der Klasse III: eine randomisierte klinische Studie[*]

Treatment of Class III Multiple Gingival Recessions: A Randomized-Clinical Trial
S. Aroca
1   Department of Periodontology, Faculty of Dentistry, University of Szeged, Szeged, Hungary
,
T. Keglevich
2   Department of Periodontology, Semmelweis University, Budapest, Hungary
,
D. Nikolidakis
3   Department of Periodontology and Biomaterials, Dental School, University Medical Center Nijmegen, Nijmegen, The Netherlands
,
I. Gera
2   Department of Periodontology, Semmelweis University, Budapest, Hungary
,
K. Nagy
4   Departent of Oral surgery, Faculty of Dentistry, University of Szeged, Szeged, Hungary
,
R. Azzi
5   Department of Periodontology, Paris – Denis Diderot University, UFR of Odontology, Paris, France
,
D. Etienne
6   Department of Periodontology, Service of Odontology, Pitié-Salpêtrière Hospital, AP-HP, Paris – Denis Diderot University, UFR of Odontology, Paris, France
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Publikationsverlauf

Publikationsdatum:
30. Dezember 2011 (online)

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Zusammenfassung

Hintergrund:

Ziel der vorliegenden kontrollierten randomisierten Studie im Split-Mouth-Design war es zu untersuchen, ob sich das Behandlungsergebnis bei multiplen Rezessionen der Klasse III mit einer modifizierten Tunneltechnik und einem Bindegewebstransplantat unter Verwendung von Schmelzmatrixproteinen gegenüber dem bloßen chirurgischen Verfahren verbessert.

Material und Methoden:

In die Studie wurden an einer Klinik für Parodontologie insgesamt 20 gesunde Probanden im durchschnittlichen Alter von 31,7 Jahren aufgenommen. Die Patienten hatten mindestens 3 benachbarte Gingivarezessionen auf beiden Seiten eines Kiefers. Sie wurden mithilfe einer modifizierten Tunneltechnik und einem Bindegewebstransplantat behandelt. Auf der Testseite wurde zusätzlich ein Schmelzmatrixprotein verwendet. Zu Beginn der Studie, nach 28 Tagen sowie 3, 6 und 12 Monate später wurden klinische Befunde erhoben. Die Ergebnisse werden patientenbezogen vorgelegt.

Ergebnisse:

Die durchschnittliche Wurzeldeckung betrug nach einem Jahr in der Testgruppe 82% und in der Kontrollgruppe 83%. Eine vollständige Wurzeldeckung fand sich nach einem Jahr bei insgesamt 8 (38%) der 20 Operationen (Test- und Kontrollgruppe).

Schlussfolgerungen:

Die Ergebnisse nach einem Jahr lassen darauf schließen, dass die modifizierte Tunneltechnik in Verbindung mit einem Bindegewebstransplantat zu vorhersagbaren Ergebnissen bei der Behandlung von multiplen Gingivarezessionen der Klasse III führt. Die zusätzliche Verwendung von Schmelzmatrixproteinen hatte keine Auswirkungen auf die durchschnittlichen klinischen Ergebnisse.

Abstract

Background:

The aim of this controlled randomized split-mouth study was to evaluate whether a modified tunnel/connective tissue graft (CTG) technique – enamel matrix derivative (EMD) combination will improve the treatment of multiple class III recession when compared with the same technique alone.

Materials and methods:

20 healthy subjects with a mean age of 31.7 years, were enrolled for the trial in a university periodontal clinic. Patients with at least 3 adjacent gingival recessions on both sides of the mouth were treated with a modified tunnel/CTG technique. On the test side, an EMD was used in addition. Clinical parameters were measured at baseline, 28 days, 3, 6 and 12 months after the surgery.

Results are presented at the subject level.

Results:

The mean root coverage from baseline to 1 year post-surgery was 82% for the test group and 83% for the control group. Complete root coverage was achieved at 1 year in 8 (38%) of the 20 surgeries (experimental and control group).

Conclusions:

1-year results indicate that the modified tunnel/CTG technique is predictable for the treatment of multiple class III recession-type defects. The addition of EMD does not enhance the mean clinical outcomes.

Schlüsselwörter

Bindegewebstransplantat - Tunneltechnik in Kombination mit koronalem Verschiebelappen - Schmelzmatrixproteine - Rezessionen der Miller-Klasse III - multiple Gingivarezessionen

Key words

connective tissue graft - coronally advanced modified tunnel - enamel matrix derivative - Miller’s class III recessions - multiple gingival recessions
*

* Der Artikel wurde im Original veröffentlicht im J Clin Periodontol 2010; 37: 88–97. Die deutsche Veröffentlichung erfolgt mit freundlicher Genehmigung.


 

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