3种增宽种植体颊侧角化龈方法的临床效果对比  

Comparison of three methods for augmenting peri-implant buccal keratinized mucosa

作　　者：蔺世晨 刘航 吴雪 李鑫 季一鸣 段少宇 Lin Shichen;Liu Hang;Wu Xue;Li Xin;Ji Yiming;Duan Shaoyu(Department of Stomatology,Electric Power Teaching Hospital,Capital Medical University,Beijing 100073,China)

机构地区：[1]首都医科大学电力教学医院口腔科,北京100073

出　　处：《首都医科大学学报》2023年第2期316-321,共6页Journal of Capital Medical University

基　　金：国中康健集团研究开发项目(02020003)。

摘　　要：目的 探讨和评价3种角化龈增宽方法在种植修复中的临床效果,为临床应用提供依据。方法 收集2019年6月至2021年6月于首都医科大学电力教学医院接受下颌后牙区种植修复治疗且存在颊侧角化龈宽度不足的患者36例,在组间均衡可比的原则上,按数字表法随机分为3组,每组12例,分别应用异体脱细胞真皮基质(acellular dermal matrix,ADM)、浓缩生长因子(concentrate growth factors,CGFs)、游离龈移植(free gingival graft,FGG)来增加种植体颊侧角化龈宽度(keratinized tissue width,KTW),术后1周采用视觉模拟评分法(Visual Analogue Scale,VAS)记录患者疼痛程度,术后6个月测量3组患者KTW及美观满意度。结果 术后6个月,3组患者的KTW分别为:ADM组(3.72±1.18)mm、CGFs组(2.92±0.72)mm、FGG组(4.65±0.91)mm,均较术前显著增加,且FGG组增加幅度[(3.49±0.79)mm]最大,高于ADM组[(2.75±0.96)mm]和CGFs组[(1.84±0.65)mm],3组间比较差异均有统计学意义(P<0.05)。术后疼痛程度VAS评分,FGG组(3.50±1.17)明显高于ADM组(2.25±1.06)和CGFs组(2.00±0.95),组间差异有统计学意义(P<0.05)。术后6个月美观满意度VAS评分,ADM组(8.67±0.89)和CGFs组(8.17±0.94)均显著高于FGG组(6.00±1.28),组间差异有统计学意义(P<0.05)。结论 ADM、CGFs、FGG 3种方法各有特点,均能够有效增加种植体颊侧KTW,临床上可以根据患者的情况和医疗机构的条件,合理进行选择。Objective To explore and evaluate the clinical effects of three methods in augmenting keratinized tissue around dental implant,provide evidence for clinical application.Methods Totally 36 patients in need for augmenting the buccal keratinized mucosa around implants in Electric Power Teaching Hospital,Capital Medical University from June 2019 to June 2021,were randomly divided into three groups with 12 cases in each group.They were treated with allogeneic acellular dermal matrix(ADM),concentrated growth factors(CGFs),free gingival graft(FGG)to increase the buccal keratinized mucosa width.The pain degree was recorded by Visual Analogue Scale(VAS)one week after surgery.The keratinized tissue width(KTW)of the three groups were measured 6 months after surgery and the aesthetic satisfaction was recorded by VAS.Results Six months after surgery,the KTW was(3.72±1.18)mm in ADM group,(2.92±0.72)mm in CGFs group and(4.65±0.91)mm in FGG group,which were significantly increased compared with the preoperative.There were significant differences in keratinized mucosa gain(ΔKTW)among ADM group[(2.75±0.96)mm],CGFs group[(1.84±0.65)mm]and FGG group[(3.49±0.79)mm](P<0.05);The VAS score of postoperative pain in FGG group(3.50±1.17)was significantly higher than that in ADM group(2.25±1.06)and CGFs group(2.00±0.95),with significant difference between three groups(P<0.05).The VAS score of aesthetic satisfaction 6-months postoperatively in ADM group(8.67±0.89)and CGFs group(8.17±0.94)were significantly higher than that in FGG group(6.00±1.28),with significant difference between three groups(P<0.05).Conclusion ADM,CGFs and FGG can effectively increase the KTW around implants,however have different characteristics.Clinically,they can be selected reasonably according to the situation of patients and the conditions of medical institutions.

关 键 词：种植体 异体脱细胞真皮基质 浓缩生长因子 游离龈移植 角化龈增宽 

分 类 号：R783[医药卫生—口腔医学]