Publication: Uso de injerto de tejido conectivo en combinación con la técnica en túnel o colgajo de avance coronal para el tratamiento de recesiones gingivales múltiples: un ensayo clínico multicéntrico aleatorizado.
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2020
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Antecedentes: Hoy en día no esta claramente establecido que la técnica de túnel sea superior al colgajo de avance coronal en términos de cubrimiento radicular y aumento de anchura de tejido queratinizado debido a la falta de evidencia. Objetivos: El objetivo principal de este ensayo clínico fue evaluar si el uso de un injerto de tejido conectivo combinado con una técnica quirúrgica en “túnel” proporciona mejores resultados en comparación con la técnica de “colgajo de avance coronal” (CAC) con injerto de tejido conectivo (TC) en términos de recubrimiento radicular completo. Métodos: Análisis intermedio de un ensayo clínico multicéntrico aleatorizado de grupos paralelos. Veintiún pacientes reclutados asignados al grupo control (CAC) o al grupo test (túnel). El cubrimiento radicular completo (CRC), la media de cubrimiento radicular, la reducción de la recesión, la PS, el NIC, la anchura de tejido queratinizado, el índice estético de cubrimiento radicular se tomaron como parámetros clínicos al tiempo basal, a los 3 y 6 meses. Además, se evaluó el tiempo quirúrgico.
Resultados: Entre los parámetros clínicos, el incremento de anchura de tejido queratinizado y el tiempo quirúrgico mostrado diferencias estadísticamente significativas entre los 2 grupos, con un aumento de anchura superior en la técnica a túnel, 1.32 (±1.38), respecto al CAC, 0.16 (± 0.66), p<0.000. El tiempo quirúrgico ha sido menor con la técnica a túnel: 44.14 min ± 6.41 respecto al CAC :71.89 min ± 13.72, (p=0.001). Sin embargo, el índice estético radicular a los 6 meses fue significativamente mayor en el grupo control: 9.76 (±0.44) en comparación con el grupo test: 9.11 (± 1.29).
Conclusiones: Valorando las limitaciones, se concluye que para la variable respuesta principal (CRC) no existen diferencias significativas entre una técnica u otra. Es necesario el tamaño muestral requerido para valorar si la técnica de túnel mas injerto presenta resultados superiores en la variable respuesta principal.
Background: Nowadays, it is not clear if tunnel technique (TUN) is superior to the coronally advanced flap (CAF) in terms of root coverage and increase of keratinized tissue width due to lack of evidence. Objective: The main objective of this study was to evaluate if the use of a TUN + connective tissue graft (CTG) gives better results than the CAF+CTG in terms of complete root coverage. Methods: This is a report of an interim-analysis of a parallel-group multicenter randomized clinical trial. Twenty one patients have been selected and allocated to the control group (CAF+CTG) or to the test group (TUN+CTG). The complete root coverage, the reduction of recession depth, the probing pocket depth, the clinical attachment levels, the keratinized tissue width and the root coverage esthetic index have been evaluated as clinical parameters at baseline and 3 and 6 months follow-up. Moreover, the surgical time has been evaluated. Results: Regarding clinical parameters, the width of keratinized tissue and the surgical time has shown statistically significant differences between the 2 groups, with an increase of width superior in the TUN+CTG group:1.32±1.38, over the CAF+CTG: 0.16± 0.66, p<0.000. The surgical time has been less in the TUN+CTG:44.14 minutes ± 6.41 than in the CAF+CTG one: 71.89 minutes ± 13.72 (p=0.001). However, the aesthetic score was significantly better for the CAF+CTG group: 9.76±0.44 in comparison with the TUN+CTG group: 9.11± 1.29. Conclusions: Despite the limitations of this ad interim analysis, both techniques have shown a similar efficacy in terms of root coverage. The complete sample is needed in order to determine the existence of superior results of the tunnel technique over the coronal advanced technique.
Background: Nowadays, it is not clear if tunnel technique (TUN) is superior to the coronally advanced flap (CAF) in terms of root coverage and increase of keratinized tissue width due to lack of evidence. Objective: The main objective of this study was to evaluate if the use of a TUN + connective tissue graft (CTG) gives better results than the CAF+CTG in terms of complete root coverage. Methods: This is a report of an interim-analysis of a parallel-group multicenter randomized clinical trial. Twenty one patients have been selected and allocated to the control group (CAF+CTG) or to the test group (TUN+CTG). The complete root coverage, the reduction of recession depth, the probing pocket depth, the clinical attachment levels, the keratinized tissue width and the root coverage esthetic index have been evaluated as clinical parameters at baseline and 3 and 6 months follow-up. Moreover, the surgical time has been evaluated. Results: Regarding clinical parameters, the width of keratinized tissue and the surgical time has shown statistically significant differences between the 2 groups, with an increase of width superior in the TUN+CTG group:1.32±1.38, over the CAF+CTG: 0.16± 0.66, p<0.000. The surgical time has been less in the TUN+CTG:44.14 minutes ± 6.41 than in the CAF+CTG one: 71.89 minutes ± 13.72 (p=0.001). However, the aesthetic score was significantly better for the CAF+CTG group: 9.76±0.44 in comparison with the TUN+CTG group: 9.11± 1.29. Conclusions: Despite the limitations of this ad interim analysis, both techniques have shown a similar efficacy in terms of root coverage. The complete sample is needed in order to determine the existence of superior results of the tunnel technique over the coronal advanced technique.
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Encuadrado en la línea de investigación Eficacia de intervenciones para el tratamiento de las enfermedades periodontales y periimplantarias.
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Unesco subjects
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