背景:为了增加角质化组织(KT)的宽度而进行的软组织移植是牙周治疗的重要方面。进行了系统评价分析,专注于非根系覆盖组织移植物。更新参考文献以反映当前文献。
方法:为了制定共识报告,小组成员提交了任何与该主题相关的新文献,这些文献符合符合系统综述的标准,并审查了这些信息以纳入本报告。制定了共识报告,以总结系统评价的结果,并指导临床医生的治疗决策过程。
结果:有46篇文章符合纳入最终分析的标准,并增加了两个条款,用于制定这份共识报告。列出了八个临床相关问题,达成共识。
结论:证据表明,当存在最佳斑块控制时,不需要最小量的KT来防止附着丧失(AL)。然而,如果斑块控制欠佳,至少需要2mm的KT。可预测地获得KT的标准程序是自体牙龈移植物。替代治疗方案的证据有限。然而,其他研究可能在某些临床情况下提供有希望的结果.
结论:患者治疗前,临床医生应该评估病因,包括炎症的作用和导致AL的各种类型的创伤。在适当的知情同意期间,应与患者一起审查最佳结果程序(自体移植)和替代方案。在支持牙周护理期间,应包括对结果的正确评估。
BACKGROUND: Soft tissue grafting for the purposes of increasing the width of keratinized tissue (KT) is an important aspect of periodontal treatment. A systematic review was analyzed, focusing on non-root coverage tissue grafts. The references were updated to reflect the current literature.
METHODS: To formulate the
consensus report, group members submitted any new literature related to the topic that met criteria fitting the systematic review, and this information was reviewed for inclusion in this report. A
consensus report was developed to summarize the findings from the systematic review and to guide clinicians in their treatment decision-making process.
RESULTS: Forty-six articles met the criteria for inclusion in the final analysis, and two articles were added that were used to formulate this
consensus report. A list of eight clinically relevant questions was posed, and
consensus statements were developed.
CONCLUSIONS: The evidence suggests that a minimum amount of KT is not needed to prevent attachment loss (AL) when optimal plaque control is present. However, if plaque control is suboptimal, a minimum of 2 mm of KT is needed. The standard procedure to predictably gain KT is the autogenous gingival graft. There is limited evidence for alternative treatment options. However, additional research may offer promising results in certain clinical scenarios.
CONCLUSIONS: Before patient treatment, the clinician should evaluate etiology, including the role of inflammation and various types of trauma that contribute to AL. The best outcome procedure (autograft) and alternative options should be reviewed with the patient during appropriate informed consent. Proper assessment of the outcome should be included during supportive periodontal care.