两种腭侧结缔组织瓣移植后的早期愈合分析  

Comparison of the Early Healing Outcome of Two Palatal Connective Tissue Flap Graft

作　　者：张建忠 陈志方[1] 刘堃[2] 龚语林 马山 无 ZHANG Jianzhong;CHEN Zhifang;LIU Kun;GONG Yulin;MA Shan;无(Hefei School of Stomatology,Anhui Medical University,Department of Oral Surgery,West District of Hefei Stomatological Hospital,Hefei 230001,Anhui Province;Department of Implantology,Hefei 230001,Anhui Province;Dental Technology Center,Hefei 230001,Anhui Province;Department of Stomatology,Changzhou Hospital of Traditional Chinese Medicine,Changzhou 213000,Jiangsu Province,China)

机构地区：[1]安徽医科大学合肥口腔临床学院,合肥市口腔医院西区口腔外科,安徽合肥230001 [2]安徽医科大学合肥口腔临床学院种植科,安徽合肥230001 [3]安徽医科大学合肥口腔临床学院口腔技术中心,安徽合肥230001 [4]常州市中医医院口腔科,江苏常州213000

出　　处：《口腔颌面外科杂志》2020年第4期239-243,共5页Journal of Oral and Maxillofacial Surgery

基　　金：合肥市科技局“借转补”项目(J2019Y03);合肥市名医工作室(合卫人〔2019〕167号)。

摘　　要：目的:观察腭侧游离结缔组织瓣与腭侧反折结缔组织瓣移植术后的愈合情况,评价2种方法的早期疗效。方法:将25例上颌前牙缺失行种植术后唇侧丰满度欠佳的病例分为2组,二期手术时分别采用腭侧游离结缔组织瓣移植术和腭侧反折结缔组织瓣移植术进行软组织增量,观察2组术后45 d内移植瓣成活率、厚度及患者疼痛程度的变化,分析2组患者早期愈合的情况。结果:腭侧游离结缔组织瓣组(游离组)移植瓣的成活率为91.67%,腭侧反折结缔组织瓣组(反折组)移植瓣的成活率为100%。2组都经历了先肿胀后收缩的短暂变化过程;术后第3天是肿胀的高峰期;术后第45天,游离组的收缩率为34.3%,反折组的收缩率为16.6%,游离组收缩程度大于反折组。2组术后的疼痛程度均为轻中度,持续2周,但游离组的疼痛程度略大于反折组。结论:在上颌前牙区利用腭侧结缔组织反折瓣行唇侧软组织增量是一种可行的方法,其早期成活率较高,体积收缩程度较小,患者疼痛程度较轻,但其长期效果还需进一步研究。Objective:To observe the healing outcome between palatal free connective tissue flap graft and palatal retrograde connective tissue flap graft,and evaluate the early efficacy of the two groups.Methods:25 cases of lack of maxillary anterior teeth with labial gingival tissue insufficiencies after implant were divided into two groups.During the secondary operation,palatal free connective tissue flap graft and palatal retrograde connective tissue flap graft were performed respectively for soft tissue augmentation.The changes and differences in survival rate,graft volume and patients′pain in the two groups within 45 days were observed,and the healing status of the two groups in the early stage were compared.Results:The survival rate of palatal free connective tissue flap group(hereinafter referred to as the free group)was 91.67%,while the survival rate of palatal retrograde connective tissue flap group(hereinafter referred to as the retrograde group)was 100%.Both flaps experienced a transient change from swelling to contraction;the 3rd day was the peak of swelling;On the 45th day,the shrinkage rate of the free group was 34.3%,and that of the retrograde group was 16.6%respectively.The free group shrinks more than the retrograde group.The postoperative pain in both groups was mild to moderate and lasted for 2 weeks,but the pain in the free group was slightly intense than that in the retrograde group.Conclusion:It is a feasible method to augment the labial soft tissue after implant by palatal retrograde connective tissue flap in the maxillary anterior region,with higher survival rate,smaller volume contraction and less pain in the early stage.However,its long-term effect needs further study.

关 键 词：上前牙 种植 美学 结缔组织瓣 移植 早期愈合 

分 类 号：R782.4[医药卫生—口腔医学]