牙龈瘤切除同期采用带蒂瓣修复对牙龈瘤患者龈沟液sICAM-1、TNF-α、IL-18水平的影响  

Effects of Instant Repair of Pedicle Flap during Gingival Tumor Resection on the Levels of sICAM-1,TNF-αand IL-18 in Gingival Crevicular Fluid of Patients with Gingival Tumor

作　　者：陆云峰 吴欣汝 马玉 LU Yunfeng;WU Xinru;MA Yu(Department of Stomatology,Suzhou Jiulong Hospital,Shanghai Jiao Tong University School of Medicine,Suzhou,Jiangsu 215000,China)

机构地区：[1]上海交通大学医学院苏州九龙医院口腔科,江苏苏州215000

出　　处：《转化医学杂志》2025年第3期28-32,共5页Translational Medicine Journal

基　　金：苏州市医学重点扶持学科项目(SZFCXK202128)。

摘　　要：目的探究牙龈瘤切除同期采用带蒂瓣修复对牙龈瘤患者龈沟液可溶性细胞间黏附因子-1(sICAM-1)、肿瘤坏死因子α(TNF-α)、白细胞介素-18(IL-18)的影响。方法回顾性选取2021年1月至2024年1月上海交通大学医学院苏州九龙医院口腔科收治的105例牙龈瘤患者,根据治疗方式将患者分为对照组(47例)和研究组(58例),对照组接受牙龈切除加翻瓣修复治疗,研究组接受牙龈瘤切除同期带蒂瓣修复治疗。比较2组患者手术前后龈沟液sICAM-1、TNF-α、IL-18水平,牙周情况,牙龈情况,术后美学效果,术后复发情况。结果2组患者术后龈沟液sICAM-1、TNF-α、IL-18水平逐渐降低(P<0.05),且研究组术后1个月与3个月时龈沟液sICAM-1、TNF-α、IL-18水平低于对照组(P<0.05);2组患者术后1个月与3个月时术后附着力损失(AL)、牙周探查深度(PD)、牙菌斑指数(PLI)、龈沟出血指数(SBI)等牙周指标水平均较术前降低,且呈逐渐降低趋势(P<0.05),术后研究组AL、PD、PLI、SBI等牙周指标水平均低于对照组(P<0.05);2组患者术后即刻、术后1个月、术后3个月角化龈宽度逐渐变大(P<0.05),研究组患者术后即刻、术后1个月、术后3个月角化龈宽度均高于对照组(P<0.05),2组患者术后即刻、术后1个月、术后3个月根面覆盖率比较,差异无统计学意义(P>0.05),研究组患者术后即刻、术后1个月、术后3个月根面覆盖率均高于对照组(P<0.05);研究组患者美学效果优良率较对照组高(P<0.05);2组患者复发率比较,差异无统计学意义(0 vs 4.26%,P>0.05)。结论牙龈瘤患者行牙龈瘤切除同期采用带蒂瓣修复有助于提高修复效果,降低龈沟液sICAM-1、TNF-α、IL-18水平,具有较高的临床应用价值。Objective To investigate the effects of instant repair pedicle flap during gingival tumor resection on soluble intercellular adhesion molecule-1(sICAM-1),tumor necrosis factor-α(TNF-α)and interleukin-18(IL-18)in gingival crevicular fluid of patients with gingival tumor.Methods A retrospective analysis included 105 patients with gingival tumor admitted from January 2021 to January 2024.Patients were divided into a control group(n=47,receiving gingival resection with flap repair)and a study group(n=58,undergoing instant pedicle flap repair during tumor resection).The levels of sICAM-1,TNF-αand IL-18 in gingival crevicular fluid,periodontal condition,gingival condition,postoperative aesthetic effect and postoperative recurrence were compared between the two groups before and after operation.Results The levels of sICAM-1,TNF-αand IL-18 in gingival crevicular fluid of the two groups gradually decreased after surgery(P<0.05),and those levels in the study group were lower than the control group at 1 and 3 months after surgery(P<0.05);Periodontal indexes such as adhesion loss(AL),periodontal exploration depth(PD),plaque index(PLI)and gingival sulci bleeding index(SBI)in the two groups at 1 and 3 months after surgery decreased,and showed a gradually decreasing trend(P<0.05).The values of periodontal indexes such as AL,PD,PLI and SBI in the study group were lower than those in the control group(P<0.05);The keratinized gingival width of the two groups gradually increased immediately,1 month and 3 months after surgery(P<0.05),and it in the study group was higher than the control group(P<0.05).There was no statistically significant difference in the root surface coverage of the two groups immediately,1 month and 3 months after surgery(P>0.05),but it in the study group was higher than the control group(P<0.05);The rate of aesthetic effect in the study group was higher than that in the control group(P<0.05);There was no statistically significant difference in the recurrence rate between the two groups(0 vs 4.26%,P>0.05).Con

关 键 词：牙龈瘤 牙龈瘤切除 带蒂瓣修复 可溶性细胞间黏附因子-1 肿瘤坏死因子α 白细胞介素-18 

分 类 号：R781.4[医药卫生—口腔医学]