游离龈瓣移植术和根向复位瓣增加种植区域角化龈效果的临床观察  

Clinical study of the effect of free gingival graft and apically repositioned flap surgery on peri-implant keratinized gingival augmentation

作　　者：乔敏[1] 张凯[1] 董静[1] 徐宝华[1] 

机构地区：[1]中日友好医院口腔医学中心,北京100029

出　　处：《中华口腔医学杂志》2016年第10期605-609,共5页Chinese Journal of Stomatology

摘　　要：目的：通过观测根向复位瓣和游离龈瓣移植术术前及术后的相关指标，对比分析二者增加角化龈的效果，以期为临床提供参考。方法对30例下颌磨牙区角化牙龈不足的种植患者一期进行埋入式种植，分为3组：第1组（平均年龄41岁，10例）和第2组（平均年龄25岁，10例）在一期种植后2个月行游离龈瓣移植术，3个月后行种植二期手术；第3组（平均年龄44岁，10例）在一期种植后3个月行种植二期和根向复位瓣手术。在游离龈瓣移植术和根向复位瓣术术前测量缺牙区角化龈宽度，术中测量角化龈厚度。术后1、6个月分别测量角化龈宽度，并对手术效果进行比较。结果移植术后1个月，第1、2组种植体颊侧角化龈宽度分别为（3.1±1.2）、（3.5±1.0）mm，两组差异无统计学意义（P〉0.05）；移植术后6个月第1、2组角化龈宽度分别为（3.0±1.3）和（3.5±1.0）mm，两组差异亦无统计学意义（P〉0.05）。第3组患者根向复位瓣术后1个月种植体颊侧角化龈宽度为（2.6±0.5）mm，术后6个月为（1.9±0.3）mm，与第1组（术后1、6个月时角化龈宽度）相比差异均有统计学意义（P=0.008，P=0.000）。结论游离龈瓣移植和根向复位瓣均可以增加种植区域的角化龈宽度；游离龈瓣移植在种植后6个月内较根向复位瓣角化龈增量更多；年龄对游离龈瓣移植增加角化龈的效果影响不大。Objective To compare and analyze the clinical outcomes of apically repositioned flap surgery and free gingival graft on keratinized gingival augmentation. Methods Totally 30 partially edentulous patients treated with submerged implant surgery in mandibular molar area were recruited and divided into three groups：group 1（mean age：41 years） and group 2 （mean age：25 years） received free gingival graft 1 month after submerged implant surgery and second stage implant surgery3 months after submerged implant surgery;group 3（mean age：44 years） received apically repositioned flap and second stage implant surgery 3 months after submerged implant surgery. The widths of keratinized gingiva were measured respectively at the time before the apically repositioned flap surgery/free gingival graft and 1 month, 6 months after the surgery. The thickness of keratinized gingiva was measured during the operation. Results The widths of peri-implant keratinized gingiva of group 1 and group 2 were （3.1 ± 1.2） mm and （3.5 ± 1.0） mm 1 month after the free gingival graft surgery, （3.0 ± 1.3） mm and （3.5 ± 1.0） mm 6 months after the free gingival graft surgery, respectively. The widths of peri-implant keratinized gingiva in group 1 and group 2 demonstrated no statistically significant differences（P〉0.05）. The widths of peri-implant keratinized gingiva of group 3 was （2.6±0.5） mm 1 month after the apically repositioned flap surgery, （1.9±0.3） mm 6 months after the apically repositioned flap surgery, respectively. The widths of peri-implant keratinized gingiva（1 month and 6 months after the apically repositioned flap surgery） in group 3 showed statistically significant differences when compared with group 1 and group 2（P=0.008, P=0.000）. Conclusions The implant area treated with free gingival graft or apically repositioned flap exhibited increased width of the keratinized gingiva. The implants treated with free gingival graft exhibited more increased width of the keratinized gingiv

关 键 词：牙龈 游离龈瓣移植术 根向复位瓣 角化龈 

分 类 号：R783[医药卫生—口腔医学]