BackgroundThis study evaluated the influence of the adjunctive application of a cross‐linked hyaluronic acid (HA) in the treatment of multiple gingival recessions, using a modified coronally advanced tunnel (MCAT) technique and subepithelial connective tissue graft (SCTG) (MCAT+SCTG±HA).MethodsA randomized, split‐mouth, double‐masked comparison of the effects of MCAT+HA+SCTG (test) versus MCAT+SCTG (control) in the treatment of multiple, contralateral gingival recessions with clinical, esthetic, and histological evaluations was carried out. All samples were stained with hematoxylin and eosin, Masson's trichrome, Verhoeff–Van Gieson, and Alcian blue stain for semiquantitative evaluation. The primary outcome variable was 12‐month mean root coverage (MRC).ResultsTwenty‐four patients with 266 gingival recessions received both control and test treatments (133 recessions per group). 12‐month MRC of the MCAT+HA+SCTG group was not significantly different from the MCAT+SCTG group with 84.32%± 34.46% and 85.71%± 36.43%, respectively (p = 0.991). Both treatment modes produced favorable esthetic outcomes (root coverage esthetic score [RES] 9.51± 1.01 tests vs. 9.26± 1.10 controls, p = 0.7292). However, the application of HA improved soft tissue texture (p = 0.0091). The remaining end point measures did not differ significantly between groups. Histological evaluation showed a significantly greater number of elastic fibers and a moderate increase in collagen fiber density in biopsy samples taken from the test sides when compared to the control sides (p = 0.0419 and p = 0.300, respectively).ConclusionsMCAT+SCTG is an effective procedure in the treatment of multiple recession Type 1 (RT1) and RT2 recessions. There were no statistically significant differences in evaluated clinical treatment outcomes in the MCAT+HA+SCTG group compared to the MCAT+SCTG group within a period of 12 months. The application of HA increased collagen and elastic fiber density.

中文翻译：

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隧道技术和上皮下结缔组织移植物，有或没有交联透明质酸，治疗多发性牙龈萎缩：一项随机临床试验的 12 个月结果


背景本研究使用改良冠状高级隧道 （MCAT） 技术和上皮下结缔组织移植物 （SCTG） （MCAT+SCTG±HA） 评估了交联透明质酸 （HA） 辅助应用在治疗多发性牙龈萎缩中的影响。方法对 MCAT+HA+SCTG（测试）与 MCAT+SCTG（对照）治疗多发性对侧牙龈退缩的影响进行随机、分口、双盲比较，包括临床、美学和组织学评估。所有样品均用苏木精和伊红、Masson 三色、Verhoeff-Van Gieson 和 Alcian 蓝染色进行半定量评估。主要结果变量是 12 个月平均根覆盖率 （MRC）。结果24 例牙龈萎缩患者 266 例接受了对照和试验治疗 （每组 133 例牙龈萎缩）。MCAT+HA+SCTG 组的 12 个月 MRC 与 MCAT+SCTG 组无显著差异，分别为 84.32%±34.46% 和 85.71%± 36.43% （p = 0.991）。两种治疗模式均产生了良好的美学结局 （牙根覆盖率美学评分 [RES] 9.51± 1.01 次测试与 9.26± 1.10 对照组，p = 0.7292）。然而，HA 的应用改善了软组织质地 （p = 0.0091）。其余终点测量在组间没有显著差异。组织学评估显示，与对照组相比，从测试侧采集的活检样本中弹性纤维的数量显着增加，胶原纤维密度适度增加 （分别为 p = 0.0419 和 p = 0.300）。结论MCAT+SCTG 是治疗多发性衰退 1 型 （RT1） 和 RT2 衰退的有效方法。 在 12 个月内，MCAT+HA+SCTG 组与 MCAT+SCTG 组相比，评估的临床治疗结果无统计学意义差异。HA 的应用增加了胶原蛋白和弹性纤维的密度。