口腔黏膜下植入软组织扩张器对局部血液微循环的影响

Effect of submucosal implantation of soft tissue expander on blood microcirculation

目的探讨软组织扩张器移植术以及术后扩张器扩张过程中对术区血运微循环的影响。方法选取7只成年比格犬,拔除比格犬双侧所有前磨牙,并去除部分下颌牙槽骨以及软组织,建立下颌牙槽骨及软组织缺损模型。6周后,在实验侧黏膜下植入软组织扩张器,对照侧不进行处理。并在手术前、局麻后2min、即刻手术后以及术后3天和5周的5个时间点,利用多普勒激光对局部血供水平进行检测。结果术后术区未出现任何并发症。局麻后2min实验侧血供检测值出现显著下降,即刻手术后并未出现持续性下降。血供检测值在术后3天较局麻后2min以及即刻手术后显著性上升,恢复至基线水平,与对照侧无明显差异。术后5周,实验侧血供检测值维持在基线水平,与对照侧无明显差异。结论黏膜下植入软组织扩张器,仅引起术区局部暂时性短时间的血供不足,对术区局部愈合以及软组织扩张过程中的血液微循环并未造成长时间的持续性损害。

Objective To investigate the effect of submucosal implantation of self-filling osmotic tissue expanders on mucosal blood microcirculation. Methods In 7 beagle dogs,on both sides all premolars were extracted. Toothsupporting bone and excess soft tissue were removed to create a resorbed edentulous alveolar ridge. After six weeks,soft tissue expanders were implanted into a submucosal pouch at randomly selected test sites,the contralateral sites were untreated. Microcirculation was assessed using laser doppler flowmerty before surgery,2 minutes after local anaesthesia,immediately after surgery, and after 3 days and 5 weeks. Results No postoperative complications occurred. Local anaesthesia caused a significant decrease of blood flow from baseline,but no additional significant decrease was recorded after completion of surgery. Blood flow showed significant increases 3 days after surgery. Blood flow returned to unimpaired baseline levels 3 day after surgery. Moreover,blood flow remained at the baseline levels 5 weeks after surgery. Conclusion Submucosal implantation of self-filling osmotic tissue expanders resulted in only momentary disturbance of microcirculation. There was no persistent interference to blood microcirculation during wound healing and soft tissue expansion process.