Retalho posicionado coronariamente associado ou não ao enxerto de matriz colágena xenógena no tratamento de dentes que apresentam recessão gengival associada à lesão cervical não-cariosa parcialmente restauradas com resina composta: estudo clínico controlado randomizado
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Data
2019-02-15
Autores
Silveira, Camila Augusto [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O objetivo do presente estudo foi avaliar um novo protocolo multidisciplinar por meio de um estudo clínico randomizado. Para tal, foram selecionados 62 pacientes alocados aleatoriamente em um dos seguintes grupos: Grupo Teste (n=31), restauração parcial da lesão cervical e cirurgia para recobrimento radicular com enxerto de enxerto de matriz colágena xenógena de origem suína (CAF + MC+ R), Grupo Controle (n=31), restauração parcial da lesão cervical e recobrimento radicular sem enxerto (CAF). Os grupos foram comparados quanto ao sangramento à sondagem (SS), acúmulo de biofilme (IP), redução na recessão gengival (RGR) ganho no nível clínico de inserção (NIC), redução da hipersensibilidade dentinária (SD) e na avaliação estética (MRES) durante um período de 1 ano. Os parâmetros de altura, largura e profundidade da lesão cervical (ALC, LLC e PLC) e altura e espessura de tecido queratinizado (ATQ e ETQ), foram colocados como variáveis independentes em um modelo de regressão linear múltipla para avaliar a influência dos mesmos no resultado final dos procedimentos. Após 1 ano, as porcentagens médias de recobrimento da altura da lesão cervical não-cariosa foram de 52,83% para o grupo (CAF+R) e 52,65 % para o grupo (CAF+MG+R), sem diferença estatística entre eles. Foi notada diferença estatisticamente significante quanto à altura e a espessura do tecido queratinizado a favor do grupo com mucograft. Nos demais parâmetros, não houve diferenças significantes. Assim pode-se concluir que os dois tratamentos resultaram em significativa redução do defeito combinado, sem diferença entre os tratamentos, embora benefício adicional relacionado à altura e espessura de tecido queratinizado tenha sido observado quando o enxerto xenógeno de matriz de colágeno foi utilizado.
The aim of this study is to evaluate a new multidisciplinary protocol by means of a randomized controlled clinical trial. Were it selected 62 patients who will be randomly allocated to one of the following groups: Test group (n = 31), partial restoration of cervical lesion and surgery for root coverage with graft collagen matrix xenogenous (MCG + PR) and control group (n = 31), partial restoration of cervical lesion and surgery for root coverage without connective tissue graft (CAF + PR). The groups were compared as to bleeding on probing (BOP), biofilm accumulation (IP), relative gingival recession (RGR) clinical attachment level (CAL), decrease of dentin hypersensitivity (DH) and aesthetic evaluation (AE) for a period of 1 year. The parameters of height, width and depth of the cervical lesion (CLH, CLW and CLD) and height and thickness of keratinized tissue (KTH and KTT), were placed as independent variables in a multiple linear regression model to evaluate their influence on the final outcome of the procedures. Average percentage rates of root coverage for test and control group were 52.83% and 53.65%, respectively. No significant statistical difference between test and control was observed regarding root coverage. A statistically significant difference was observed when height and thickness of the keratinized tissue favored the group with mucograft. When the other parameters were compared between the two groups, no difference was found. Thus, it can be concluded that the two treatments resulted in a significant reduction of the combined defect, with no difference between the treatments, although additional benefit related to keratinized tissue height and thickness was observed when the xenogen matrix of collagen was used.
The aim of this study is to evaluate a new multidisciplinary protocol by means of a randomized controlled clinical trial. Were it selected 62 patients who will be randomly allocated to one of the following groups: Test group (n = 31), partial restoration of cervical lesion and surgery for root coverage with graft collagen matrix xenogenous (MCG + PR) and control group (n = 31), partial restoration of cervical lesion and surgery for root coverage without connective tissue graft (CAF + PR). The groups were compared as to bleeding on probing (BOP), biofilm accumulation (IP), relative gingival recession (RGR) clinical attachment level (CAL), decrease of dentin hypersensitivity (DH) and aesthetic evaluation (AE) for a period of 1 year. The parameters of height, width and depth of the cervical lesion (CLH, CLW and CLD) and height and thickness of keratinized tissue (KTH and KTT), were placed as independent variables in a multiple linear regression model to evaluate their influence on the final outcome of the procedures. Average percentage rates of root coverage for test and control group were 52.83% and 53.65%, respectively. No significant statistical difference between test and control was observed regarding root coverage. A statistically significant difference was observed when height and thickness of the keratinized tissue favored the group with mucograft. When the other parameters were compared between the two groups, no difference was found. Thus, it can be concluded that the two treatments resulted in a significant reduction of the combined defect, with no difference between the treatments, although additional benefit related to keratinized tissue height and thickness was observed when the xenogen matrix of collagen was used.
Descrição
Palavras-chave
Recessão gengival, Abrasão dental, Gingival recession, Tooth abrasion