陈志贤 钟锡鹏 黄容裕 刘晓桢 黄素平

【摘要】 目的：對比分析MillerⅠ、Ⅱ类牙龈退缩治疗中隧道技术联合脱细胞真皮基质补片与冠向复位瓣术联合结缔组织移植治疗的应用效果。方法：选取2018年4月-2019年4月本院60例MillerⅠ、Ⅱ类牙龈退缩手术治疗患者，随机分两组，每组30例。对照组使用冠向复位瓣术联合结缔组织移植治疗，研究组使用隧道技术联合脱细胞真皮基质补片治疗。比较两组治疗前后患牙根面覆盖率、临床指标、美学及疼痛评分。结果：两组治疗前患牙根面覆盖率、疼痛评分比较，差异均无统计学意义（P>0.05）;研究组治疗后各指标均优于对照组（P<0.05）。两组治疗前后牙周袋探针深度、牙龈退缩深度、临床附着水平、牙龈退缩宽度、角化龈宽度、牙龈厚度比较，差异均无统计学意义（P>0.05）。两组治疗前红色美学评分、白色美学评分比较，差异均无统计学意义（P>0.05）;研究组治疗后各评分均高于对照组（P<0.05）。结论：MillerⅠ、Ⅱ类牙龈退缩患者治疗中隧道技术联合脱细胞真皮基质补片的应用效能够达到与冠向复位瓣术联合结缔组织移植相近的疗效，并有效缓解患者痛苦，提升美学效果。

【关键词】 MillerⅠ类 MillerⅡ类 牙龈退缩 隧道技术 脱细胞真皮基质补片 冠向复位瓣术 结缔组织移植

Study on Clinical Value of Tunneling Technique Combined with Acellular Dermal Matrix Patch in MillerⅠ and Ⅱ Gingival Recession Patients/CHEN Zhixian， ZHONG Xipeng， HUANG Rongyu， LIU Xiaozhen， HUANG Suping. //Medical Innovation of China， 2021， 18（12）： 0-073

[Abstract] Objective： To compare and analyze the application effect of tunneling technique combined with acellular dermal matrix patch and coronal reduction flap combined with connective tissue transplantation in the treatment of MillerⅠ and Ⅱ gingival recession. Method： A total of 60 type gingival recession patients in our hospital from April 2018 to April 2019 were randomly divided into two groups， 30 cases in each group. The control group was treated with coronal reduction flap combined with connective tissue transplantation， and the study group was treated with tunneling technique combined with acellular dermal matrix patch. The root surface coverage， clinical indexes， aesthetic scores， and pain scores were compared between two groups before and after treatment.  Result： There were no significant differences in the root surface coverage and pain scores between two groups before treatment （P>0.05）; after treatment， the study group were superior to the control group （P<0.05）. There were no significant differences in the depth of periodontal pocket probe， gingival recession depth， clinical attachment level， gingival recession width， keratinized gingival width and gingival thickness between two groups before and after treatment （P>0.05）. Before treatment， there were no significant differences in the red aesthetic score and white aesthetic score between two groups （P>0.05）; after treatment， the study group were higher than those of the control group （P<0.05）. Conclusion： The application effect of tunneling technique combined with acellular dermal matrix patch in the treatment of patients with MillerⅠ and Ⅱ gingival recession can achieve a similar effect to that of coronal reduction flap combined with connective tissue transplantation， and effectively relieve the pain of patients and enhance the aesthetic effect.

[Key words] MillerⅠ classes MillerⅡ classes Gingival recession Tunneling technique Acellular dermal matrix patch Coronal reduction flap Connective tissue transplantation

First-authors address： Zhongshan Peoples Hospital， Zhongshan 528400， China

doi：10.3969/j.issn.1674-4985.2021.12.016

牙齦退缩是牙周疾病中发生率较高的一种，发生此类情况的原因主要是牙龈边缘向釉牙骨质界根方向退缩，严重影响患者正常生活和牙齿美观，给其生理以及心理带来较大的痛苦[1]。随着患者疾病的不断发展，患者会出现根面磨损、牙齿敏感或者根面龋情况，还会致使患者口腔内细菌滋生，为其营造温润的生存环境，不利于患者口腔卫生和健康[2]。MillerⅠ、Ⅱ类牙龈退缩是较为常见的退缩情况，临床治疗中常用的方式为手术治疗，随着相关手术研究的不断开展，临床治疗中可供选择的手术方式也越来越多，不同手术的治疗效果也有所不同[3-4]。为此，本……