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Abstract：
BACKGROUND: The present study evaluated the biomechanical characteristics of cyanoacrylate-based tissue adhesive (TA) compared to surgical sutures in coronally advanced flap (CAF) procedures using an ex-vivo model.
METHODS: Thirty-six half-pig mandibles were divided into three groups, n=12 each: (I) CAF fixed with sutures (sling and tag suture technique), (II) CAF fixed with TA, and (III) CAF fixed with sutures and TA. At mandibular premolars, gingival recession defects extending 3 mm apical to the cemento-enamel junction (CEJ) were created. CAF procedures were performed using a split-full-split approach, with coronal advancement of the flap to 1 mm above the marked CEJ and stabilization according to the respective groups I-III. Marginal flap stability against pull-of forces (maximum tensile force) was measured with a universal material testing machine until the CEJ became visible.
RESULTS: The comparison between groups I-III demonstrated a significantly increased maximum tensile force for the TA (II) compared to the suture group (I) (p<0.001). A significantly increased maximum tensile force was found for the suture and TA (III) compared to the suture group (I) (p<0.001). There was also a significantly increased maximum tensile force in the suture and TA (III) compared to the TA group (II) (p<0.001).
CONCLUSIONS: The results suggest that cyanoacrylate-based TA can increase marginal flap stability compared to sutures in CAF procedures.
CONCLUSIONS: Cyanoacrylate-based TA can be considered a useful and valuable adjunct to conventional suturing techniques in periodontal plastic surgery, especially in cases where high flap stability is required. The results of this ex-vivo study can only be transferred to the clinical situation with limitations. Clinical long-term follow-up data must be generated.
METHODS: Thirty-six half-pig mandibles were divided into three groups, n=12 each: (I) CAF fixed with sutures (sling and tag suture technique), (II) CAF fixed with TA, and (III) CAF fixed with sutures and TA. At mandibular premolars, gingival recession defects extending 3 mm apical to the cemento-enamel junction (CEJ) were created. CAF procedures were performed using a split-full-split approach, with coronal advancement of the flap to 1 mm above the marked CEJ and stabilization according to the respective groups I-III. Marginal flap stability against pull-of forces (maximum tensile force) was measured with a universal material testing machine until the CEJ became visible.
RESULTS: The comparison between groups I-III demonstrated a significantly increased maximum tensile force for the TA (II) compared to the suture group (I) (p<0.001). A significantly increased maximum tensile force was found for the suture and TA (III) compared to the suture group (I) (p<0.001). There was also a significantly increased maximum tensile force in the suture and TA (III) compared to the TA group (II) (p<0.001).
CONCLUSIONS: The results suggest that cyanoacrylate-based TA can increase marginal flap stability compared to sutures in CAF procedures.
CONCLUSIONS: Cyanoacrylate-based TA can be considered a useful and valuable adjunct to conventional suturing techniques in periodontal plastic surgery, especially in cases where high flap stability is required. The results of this ex-vivo study can only be transferred to the clinical situation with limitations. Clinical long-term follow-up data must be generated.
摘要：
背景：本研究使用离体模型评估了基于氰基丙烯酸酯的组织粘合剂（TA）与冠状推进皮瓣（CAF）手术中手术缝合线相比的生物力学特征。
方法:将36只半猪下颌骨分为三组,每个n=12：（I）用缝线固定的CAF（吊带和标签缝合技术），(二)用TA固定的CAF,(III)用缝线和TA固定的CAF。在下颌前磨牙，创建了延伸到牙骨质-牙釉质交界处（CEJ）顶端3毫米的牙龈凹陷缺陷。CAF程序是使用分裂-完全分裂方法进行的，将皮瓣冠状推进至标记的CEJ上方1mm，并根据相应的I-III组进行稳定。用通用材料测试机测量边缘襟翼抵抗拉力(最大拉力)的稳定性,直到CEJ变得可见。
结果：I-III组之间的比较表明，与缝合组（I）相比，TA（II）的最大拉力显着增加（p<0.001）。与缝合线组(I)相比,缝合线和TA(III)的最大拉力显著增加(p<0.001)。与TA组(II)相比,缝合线和TA(III)中的最大张力也显著增加(p<0.001)。
结论：结果表明，与CAF手术中的缝线相比，基于氰基丙烯酸酯的TA可以增加边缘皮瓣的稳定性。
结论：基于氰基丙烯酸酯的TA可以被认为是牙周整形手术中常规缝合技术的有用和有价值的辅助手段，特别是在需要高襟翼稳定性的情况下。该离体研究的结果只能转移到具有局限性的临床情况。必须生成临床长期随访数据。
方法:将36只半猪下颌骨分为三组,每个n=12：（I）用缝线固定的CAF（吊带和标签缝合技术），(二)用TA固定的CAF,(III)用缝线和TA固定的CAF。在下颌前磨牙，创建了延伸到牙骨质-牙釉质交界处（CEJ）顶端3毫米的牙龈凹陷缺陷。CAF程序是使用分裂-完全分裂方法进行的，将皮瓣冠状推进至标记的CEJ上方1mm，并根据相应的I-III组进行稳定。用通用材料测试机测量边缘襟翼抵抗拉力(最大拉力)的稳定性,直到CEJ变得可见。
结果：I-III组之间的比较表明，与缝合组（I）相比，TA（II）的最大拉力显着增加（p<0.001）。与缝合线组(I)相比,缝合线和TA(III)的最大拉力显著增加(p<0.001)。与TA组(II)相比,缝合线和TA(III)中的最大张力也显著增加(p<0.001)。
结论：结果表明，与CAF手术中的缝线相比，基于氰基丙烯酸酯的TA可以增加边缘皮瓣的稳定性。
结论：基于氰基丙烯酸酯的TA可以被认为是牙周整形手术中常规缝合技术的有用和有价值的辅助手段，特别是在需要高襟翼稳定性的情况下。该离体研究的结果只能转移到具有局限性的临床情况。必须生成临床长期随访数据。
