摘要
目的:评价条带状游离龈移植增宽种植区角化龈的临床治疗效果。方法:纳入角化龈不足的患者29例(40个牙位),在种植前行条带状游离龈移植增宽种植区角化龈,记录不同时期角化龈宽度、收缩率、术后并发症发生情况、止痛药服用量及组织学特征。结果:29例患者均成功,术前角化龈宽度(0.99±0.77)mm,移植术后即刻颊舌侧膜龈联合间距离(9.58±1.45)mm。1.5个月(种植术前)角化龈宽度(7.46±1.14)mm,收缩率24.5%,与移植术后即刻相比差异有统计学意义(P=0.000)。种植术后即刻愈合基台颊侧角化龈宽度(5.56±0.76)mm,3个月宽度为(4.78±0.65)mm,与种植术后即刻相比差异有统计学意义(P=0.000);6个月(戴牙后即刻)冠颊侧角化龈宽度(4.31±0.52)mm,12个月(戴牙后6个月)宽度为(4.29±0.49)mm,与6个月相比差异无统计学意义(P=0.160),种植术后即刻至12个月收缩率为22.5%。移植术后1周疼痛度评分(2.90±1.05),肿胀度评分(1.72±0.65);术后2周疼痛度和肿胀度为0,止痛药服用量(66.29±37.44)mg。移植术后1.5个月HE染色显示移植区与邻近角化龈组织结构相同。所有患者均完成种植修复,随访期间无失败病例。结论:条带状游离龈移植可显著增宽种植区角化龈且术后反应轻。
Objective:To evaluate the clinical efficacy of strip free gingival grafting to widen the keratinized gingiva in the implant area.Methods:Twenty⁃nine patients(40 tooth positions)with keratinized gingival insufficiency were treated by strip free gingival grafting before implantation.The width,contraction rate,pain degree,swelling degree,analgesic dosage and histological characteristics were recorded in different periods.Results:All patients were successful.Preoperative keratinized gingival width of(0.99±0.77)mm,and immediately distance between the buccal lingual membrane and gingiva of(9.58±1.45)mm after surgery.The width of the keratinized gingiva at 1.5 months(before implantation)was(7.46±1.14)mm,with a contraction rate of 24.5%.The difference was statistically significant compared to grafting immediately(P=0.000).Imme⁃diately after implantation,the width of the keratinized gingiva on the buccal side of the abutment(5.56±0.76)mm,and the width at 3 months was(4.78±0.65)mm,which showed a statistically significant difference compared to immediately after surgery(P=0.000).The width of the keratinized gingiva on the coronal buccal sides at 6 months(immediately after loading)was(4.31±0.52)mm,while at 12 months(6 months after loading)it was(4.29±0.49)mm.There was no statistically signifi⁃cant difference compared to 6 months(P=0.160),and the contraction rate from immediately to 12 months after implantation was 22.5%.One week after grafting,the pain level was(2.90±1.05),and the swelling level was(1.72±0.65).Two weeks after surgery,the pain and swelling levels were 0,and the dosage of painkillers was(66.29±37.44)mg.After 1.5 months grafting,HE staining showed that the grafted area had the same tissue structure as the adjacent keratinized gingiva.All pa⁃tients completed implant restoration,and there were no failures during the follow⁃up.Conclusion:The strip free gingival graft⁃ing can significantly widen the keratinized gingiva in the implant area with mild postoperative reaction.
作者
李玉山
何修全
水宇豪
刘堃
LI Yu-shan;HE Xiu-quan;SHUI Yu-hao;LIU Kun(Hefei Stomatology Clinical College of Anhui Medical Univer-sity,Anhui Hefei 230601,China;The Fifth Clinical College of Anhui Medical University,Anhui Hefei 230601,China;Hefei Stomatology Hospital,Anhui Hefei 230601,China)
出处
《临床口腔医学杂志》
2023年第9期537-540,共4页
Journal of Clinical Stomatology
基金
合肥市卫生计生应用医学研究项目(编号:Hwk2022zc049)
安徽医科大学校科研基金项目(编号:2022xkj258)。
关键词
条带状游离龈移植
种植牙
角化龈宽度
Strip free gingival graft
Implant tooth
Width of keratinized gingiva
