隧道技术联合结缔组织移植治疗牙龈退缩的Meta分析  

Meta-analysis of Tunnel Technique Combined with Connective Tissue Graft Transplantation Therapy in the Treatment of Gingival Recession

作　　者：于尧 任贵云[1] 程亚萌 吴芃林 马雪 YU Yao;REN Guiyun;CHENG Yameng;WU Penglin;MA Xue(Department of Oral and Maxillofacial Surgery,Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Diseases,School and Hospital of Stomatology,Hebei Medical University,Shijiazhuang 050017,Hebei,China)

机构地区：[1]河北医科大学口腔医学院·口腔医院口腔颌面外科、河北省口腔医学重点实验室、河北省口腔疾病临床医学研究中心,河北石家庄050017

出　　处：《中国美容医学》2024年第7期124-129,共6页Chinese Journal of Aesthetic Medicine

基　　金：河北省科技厅重点研发计划(编号:20377747D)。

摘　　要：目的:系统评价基于临床随机对照试验下的隧道技术(Tunnel technique,TUN)联合结缔组织移植(connective tissue graft,CTG)治疗牙龈退缩的临床效果。方法:检索PubMed、Web of Science、Cochrane、Embase、知网、万方、CBM、维普关于隧道技术联合结缔组织移植治疗牙龈退缩的临床随机对照试验,检索时间为建库至2022年10月,进行资料提取及偏倚评价,运用Review Manager 5.4软件对最终纳入文献的研究数据进行Meta分析。结果:本研究共纳入10篇文献进行定量分析,Meta分析结果显示:隧道技术联合结缔组织移植在短期(6个月)与长期(≥12个月)的平均根面覆盖率(Mean root coverage,MRC)(WMD=-0.25,95%CI=-4.51~4.00,P=0.91)和角化组织宽度(Keratinized tissue width,KTW)(WMD=0.31,95%CI=-0.59~1.18,P=0.48)比较差异无统计学意义;隧道技术联合结缔组织移植与冠向复位瓣(Coronal advanced flap,CAF)联合结缔组织移植的平均根面覆盖率(WMD=-1.58,95%CI=-13.39~10.23,P=0.79)、探诊深度(Probing depth,PD)(WMD=-0.04,95%CI=-0.19~0.12,P=0.64)、根面美学评分(Root coverage esthetic score,RES)(WMD=-0.24,95%CI=-0.82~0.33,P=0.41)均差异无统计学意义;隧道技术联合结缔组织移植与冠向复位瓣联合结缔组织移植的角化组织增量(Gained keratinized tissue,GKT)(WMD=0.38,95%CI=0.04~0.72,P=0.03)差异有统计学意义。结论:隧道技术联合结缔组织移植是治疗牙龈退缩的一项可靠的手术方法,并且随时间推移,临床效果也能够获得良好的维持。Objective To systematically evaluate the clinical efficacy of tunnel technique(TUN)combined with connective tissue graft(CTG)transplantation based on clinical randomized controlled trials(RCTs).Methods PubMed,Web of Science,Cochrane,Embase,CNKI,Wanfang Data,CBM and VIP were searched for randomized controlled trials(RCTs)about tunneling technique(TUN)combined with connective tissue transplantation in the treatment of gingival recession,the sinus lift procedures were collected from inception of these database above to October 2022.Data extraction and bias evaluation were performed,The Review Manager 5.4 software was used to perform a meta-analysis of the study date ultimately included in the literature.Results 10 studies were included for quantitative analysis,Meta-analysis showed that:There was no significant difference in mean root coverage(MRC)(WMD=-0.25,95%CI=-4.51 to 4.00,P=0.91)and keratinized tissue width(KTW)(WMD=0.31,95%CI=-0.59 to 1.18,P=0.48)of TUN+CTG in short term(6th month)and long term(≥12th month).There was no significant difference between TUN+CTG and CAF+CTG in mean root coverage(WMD=-1.58,95%CI=-13.39 to 10.23,P=0.79),probing depth(WMD=-0.04,95%CI=-0.19 to 0.12,P=0.64)and root coverage esthetic score(WMD=-0.24,95%CI=-0.82 to 0.33,P=0.41).There was significant difference between TUN+CTG and CAF+CTG in gained keratinized tissue,(WMD=0.38,95%CI=0.04 to 0.72,P=0.03).Conclusion Tunnel technique combined with connective tissue transplantation is a reliable surgical method for gingival recession and the clinical effect can be maintained well over time.

关 键 词：隧道技术 结缔组织移植 牙龈退缩 临床随机对照试验 META分析 

分 类 号：R781.44[医药卫生—口腔医学]