Aim
To evaluate the long‐term (≥2 years) stability of root coverage procedures for single gingival recessions.
Materials and Methods
A complete literature search was performed up to July 2018. Randomized controlled trials (RCTs) following ≥2 years were selected. Primary outcomes were complete root coverage (CRC) and mean root coverage (MRC). Secondary outcomes were width of keratinized tissue (KTW) and patient‐centred parameters. Meta‐analysis was conducted when possible.
Results
A total of fifteen RCTs were included. The results demonstrated significantly higher MRC in short‐term than long‐term after coronally advanced flap (CAF; 7.29%, p = 0.006). When CAF combined with connective tissue graft (CTG), no significant difference was observed in CRC or MRC for short‐term versus long‐term (1.00, p = 0.97; 2.35%, p = 0.09), and it resulted in better long‐term efficacy than CAF alone in terms of CRC (0.69, p = 0.0006) and KTW (−0.63 mm, p = 0.04). For CAF plus enamel matrix derivative, the meta‐analysis showed no significant difference between the short‐term and long‐term results of CRC (1.26, p = 0.21).
Conclusions
CAF alone could result in decreased postoperative percentage of root coverage with time. CAF + CTG could maintain long‐term stability and result in better root coverage outcomes than CAF.
BackgroundInstitution-based childbirth, with the ultimate goal of universal access to skilled birth attendance (SBA), has been selected as a key strategy to reduce the maternal mortality rate in many developing countries. However, the question of how to engage traditional birth attendants (TBAs) in the advocacy campaign for SBA poses a number of challenges. This paper aims to demonstrate how TBAs in rural regions of China have been integrated into the health system under a policy of institutional delivery.MethodsResearch was conducted through literature and document reviews and individual in-depth interviews with stakeholders of the safe motherhood program in rural Guangxi Zhuang Autonomous Region, China. A total of 33 individual interviews were conducted with regional and local politicians, policy makers, health managers, health providers, civil society members, village cadres for women affairs, former TBAs, village maternal health workers, mothers and their mother-in-laws.ResultsSince 1998, TBA’s traditional role of providing in-home care during childbirth has been restructured and their social role has been strengthened in rural Guangxi. TBAs were redesigned to function as the linkage between women and the health system. A new policy in 1999 shifted the role of TBAs to village maternal health workers whose responsibilities were mainly to promote perinatal care and institution-based delivery of pregnant women. This successful transformation involved engaging with government and other actors, training TBAs for their new role, and providing incentives and sanctions for human resources management.ConclusionsThe China experience of transforming the role of TBAs in Guangxi rural area is an example of successfully engaging TBAs in promoting institution-based childbirth.
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