附着龈重建在口腔种植修复中的应用  

Application of attached gingiva reconstruction in implant-supported dental prosthesis

作　　者：李鹏[1] 姜宝岐[1] 兰晶[1] 黄海云[1] 梁晋[1] 马晓妮[1] 徐欣[1] 

机构地区：[1]山东大学口腔医学院种植中心,山东省口腔生物医学重点实验室,山东济南250012

出　　处：《上海口腔医学》2013年第2期214-218,共5页Shanghai Journal of Stomatology

摘　　要：目的:探讨种植体周围附着龈重建的方法,评估其临床应用效果及技术特点。方法:选择2011年1月—8月在山东大学口腔医院种植中心行种植二期手术且伴有附着龈不足的患者8例,共10个种植位点,应用改良根向复位瓣术在种植二期手术的同期为患者进行附着龈重建。术后4周行烤瓷冠修复,冠修复半年后复诊。分别记录术前、术后4周、冠修复半年后的有效角化黏膜宽度。记录冠修复半年后的改良菌斑指数(mPI)、探诊深度(PD)、出血指数(BI)和探诊出血位点百分比。采用SPSS 18.0软件包对数据进行Wilcoxon符号秩检验。结果:术后4周时,有效角化黏膜宽度与术前相比平均增加2.41 mm(P<0.05)。重建的角化黏膜宽度在冠修复半年后仍然保持稳定,无明显炎症并紧密贴合于烤瓷冠,平均为(2.64±0.53)mm。mPI平均为0.70±0.82,PD平均为(1.80±0.36)mm,BI平均为0.73±0.64,探诊出血位点百分比为23.3%。结论:在种植二期手术同期,采用改良根向复位瓣术能有效重建种植体周围的附着龈,短期内效果良好。PURPOSE： To explore a method of attached gingiva reconstruction around dental implants and to evaluate its clinical outcomes and technical characters. METHODS： From January 2011 to August 2011, a total of 10 implants were included in this study from 8 patients who had inadequate attached gingiva and needed to undergo secondary operation. A modified apically positioned flap technique was applied to reconstruct attached gingiva at the time of secondary operation. Crown restoration was finished 4 weeks after the operation and the patients were recalled 6 months after restoration. Effective keratinized mucosal width was recorded separately before the operation, 4 weeks after the operation and 6 months after restoration. Clinical examination was conducted 6 months after restoration including modified plaque index （mPI）, probing depth （PD）, bleeding index （BI） and percentage of bleeding on probing. Statistical analysis was performed using Wilcoxon signed rank test with SPSS18.0 software package. RESULTS： Four weeks after the operation, there was an average increase of 2.41 mm in effective keratinized mucosal width compared with the preoperative value （P〈0.05）. After 6 months of function, the newly formed keratinized mucosa remained stable and attached to the crown tightly without obvious inflammation. The mean width was （2,64±0.53） mm. Clinical examinations showed a mean mPI of 0.70±0.82, a mean PD of （1.80±0.36） mm, and a mean BI of 0.73±0.64. In terms of bleeding on probing, 23.3% of sites showed positive outcome. CONCLUSIONS： By using the modified apically positioned flap technique at the time of secondary operation, the attached gingiva around implants can be effectively reconstructed. The short-term effects are satisfactory.

关 键 词：附着龈 角化黏膜 牙种植体 根向复位瓣 软组织处理 

分 类 号：R783.6[医药卫生—口腔医学]