富血小板纤维蛋白结合冠向复位瓣在牙龈退缩中的应用

目的 评价显微手术中用冠向复位瓣(coronally advanced flap, CAF)联合富血小板纤维蛋白(platelet-rich fibrin, PRF)与单纯使用冠向复位瓣在治疗牙龈退缩(GR)中的应用效果。 方法 36例GR病人中，随机选取18例25颗GR患牙进行PRF+CAF(观察组)；余18例24颗GR患牙进行CAF(对照组)；2组均采用显微手术方法，记录并比较2组病人基线和术后3、6个月的牙周探诊深度(PD)、牙龈垂直向退缩高度(VGR)、角化龈宽度(KTH)、牙龈厚度(GT)、病人舒适度(PCS)、敏感度(HS)、美学指数(PES)以及病人总满意度。 结果 2组术前、术后PD、KTH差异均无统计学意义(P>0.05)；在根面覆盖上，2组术前、术后VGR比较差异有统计学意义(P < 0.01)；观察组术前、术后GT比较差异均有统计学意义(P < 0.01)；病人满意度(包括PCS、HS、PES)术前、术后差异均有统计学意义(P < 0.01)，特别是HS，病人术后总体比较满意。 结论 PRF膜与CAF联合治疗GR可以达到很好的根面覆盖效果，且术后GT及病人满意度比单纯使用CAF具有更突出的优点。

Application of platelet-rich fibrin combined with coronally advance flap in the treatment of gingival recession

Objective To compare the application effects between the platelet-rich fibrin(PRF) combined with coronally advanced flap(CAF) and coronally advanced flap alone in the treatment of gingival recession(GR). Methods Thirty-six patients with GR were randomly divided into the observation group(18 cases, 25 teeth with GR) and control group(18 cases, 24 teeth with GR). The observation group and control group were treated with PRF combined with CAF and CAF, respectively. The microsurgery in two groups were used.The base line, and periodontal probing depth(PD), vertical gingival regression height(VGR), keratinized gingival width(KTH), gingival thickness(GT), patient comfort(PCS), sensitivity(HS), aesthetic index(PES) and total satisfaction after 3 and 6 months of operation in two groups were recorded and compared. Results The differences of the PD and KTH in two groups between before and after operation were not statistically significant(P>0.05). In terms of root surface coverage, the difference of the VGR in two groups between before and after operation was statistically significant(P < 0.01). The difference of the GT in the observation group between before and after operation was statistically significant(P < 0.01). The differences of the patients' satisfaction(including the PCS, HS and PES) in the observation group were statistically significant between before and after surgery(P < 0.01), especially for HS, the patients were generally satisfied after surgery. Conclusions The PRF membrane combined with CAF in the treatment of GR can achieve the good root surface coverage, and the postoperative GT and patient's satisfaction have more prominent advantages compared with the CAF alone.