改良游离牙龈移植技术临床效果评价

Clinical evaluation of modified free gingival transplantation technique

目的 :评价种植体周围改良游离牙龈移植技术的临床效果。方法 :选择36例患者42个下颌后牙区种植位点,种植后颊侧龈缘中点处角化龈宽度均小于2 mm。修复前2个月采用改良游离牙龈移植技术,即供区使用个性化腭护板,受区使用个性化移植物压板。术后观察移植物的成活情况。术后即刻,术后2、6、12个月对种植体颊侧角化龈宽度进行测量。术后1、3、6 d用目测类比法(VAS)记录患者术创疼痛。采用SPSS 25.0软件包对数据进行配对t检验和单因素方差分析。结果:42个种植位点移植瓣均成活。术前种植体颊侧角化龈宽度平均(0.39±0.41)mm,术后12个月平均(4.17±0.43)mm,与术前相比,平均增加(3.78±0.21)mm,平均收缩量为(1.12±0.12)mm。结论:改良游离牙龈移植技术可有效增加种植体颊侧角化龈宽度,术后1年移植物收缩量较小,患者术后疼痛不明显。

PURPOSE: To evaluate the clinical effect of modified free gingival graft technique of the peri-implant.METHODS: There were 42 mandibular posterior area implant sites in 36 patients. The width of the keratinized gingiva at the midpoint of buccal gingival margin was less than 2 mm after implantation. Two months before restoration, modified free gingival graft technique was used, i.e. the donor site was treated with individualized palatal protective plate and the recipient site was treated with individualized graft pressure plate. The survival of the graft after operation was observed.The width of buccal keratinized gingiva was measured immediately, 2, 6, 12 months after operation. Visual analogue scale(VAS) was used to record postoperative pain of the patient 1, 3, 6 days after operation. SPSS 25.0 software package was used for t test and one-way variance analysis. RESULTS: All 42 implant sites survived. The average width of buccal keratinized gingiva of the preoperative implants was(0.39 ±0.41) mm and(4.17±0.43) mm 12 months, postoperatively;the average increase was(3.78±0.21) mm compared with preoperative measurement. The average shrinkage was(1.12±0.12) mm.CONCLUSIONS: Modified free gingival graft technique can effectively increase the width of buccal keratinized gingiva of the implants, with minimal shrinkage of the graft 1 year after operation without significant pain after operation.