附着龈重建对种植修复效果的影响

The influence of attached gingival reconstruction on the effect of implant restoration

目的探讨附着龈重建对种植修复效果的影响。方法选取收治的60例口腔种植修复治疗的患者,采用随机法将其分成两组,各30例,对照组采用常规牙龈对位缝合技术,观察组采用附着龈重建手术,统计两组患者牙龈炎症的发生率,比较二期手术、术后4周和术后6个月两组患者的角化黏膜宽度,术后6个月对比两组的探诊深度、改良菌斑指数、出血指数和龈边缘外形轮廓与附着点重建情况。结果观察组牙龈炎症发生率(6.67%)低于对照组(26.67%),差异有统计学意义(P <0.05);二期手术时观察组的角化黏膜宽度(0.40±0.16) mm与对照组(0.39±0.17) mm比较无明显差异(P> 0.05);观察组术后4周的角化黏膜宽度(2.92±0.56) mm、术后6个月的角化黏膜宽度(3.09±0.63) mm均高于对照组(1.37±0.38) mm、(1.92±0.47) mm,差异有统计学意义(P <0.05);术后6个月观察组探诊深度(1.75±0.36) mm、改良菌斑指数(0.76±0.28)、出血指数(0.63±0.29)均低于对照组(1.98±0.52) mm、(0.98±0.47)、(0.96±0.31),差异有统计学意义(P <0.05);观察组龈边缘外形轮廓与附着点重建的缺陷比例(13.33%)低于对照组(36.67%),差异有统计学意义(P <0.05)。结论在种植修复中应用附着龈重建手术能够有效降低牙龈炎的发生率,重建缺牙区角化牙龈宽度,改善红色美学的同时,为种植体提供稳定的软组织环境,最终获得良好的修复效果。

Objective To explore the influence of attached gingival reconstruction on the effect of implant restoration. Methods 60 cases treating with oral implant prosthesis were randomly divided into two groups( each 30 cases per group),the patients of control group were used conventional gum apposition suture technique,the observation group used attached gingival reconstructive surgery,the incidence rate of two groups of patients with gingival inflammation were recorded.The keratinized mucosal widths of the two groups were compared during the second stage operation,4 weeks after the operation,and 6 months after the operation. The probing depth,improved plaque index,bleeding index,the contour of gingival margin and the defect ratio of attachment point reconstruction were compared between the two groups at 6 months after operation. Results The incidence of gingival inflammation in the observation group( 6. 67%) was lower than that of the control group( 26. 67%),and the difference was statistically significant( P < 0. 05);the width of the keratinized mucosa in the observation group was( 0. 40 ± 0. 16) mm compared with the control group during the second-stage operation There was no significant difference in( 0. 39 ± 0. 17) mm of the observation group( P > 0. 05);the width of the cornified mucosa at 4 weeks postoperatively in the observation group was( 2. 92 ± 0. 56) mm,and the width of keratotic mucosa at 6 months postoperatively( 3. 09 ± 0. 63) mm were higher than those in the control group( 1. 37 ± 0. 38) mm and( 1. 92 ± 0. 47) mm,the difference was statistically significant( P < 0. 05);the observation group’s probing depth was( 1. 75 ± 0. 36) mm,modified bacteria at6 months Spot index( 0. 76 ± 0. 28) and bleeding index( 0. 63 ± 0. 29) were lower than the control group( 1. 98 ± 0. 52)mm,( 0. 98 ± 0. 47),( 0. 96 ± 0. 31),the difference was statistically significant( P < 0. 05);The defect ratio of the gingival contour and the reconstruction of the attachment point in the observation group( 13. 33%) was lower than that of the control group( 36. 67%),and the difference was statistically significant( P < 0. 05). Conclusion The application of keratinized gingival( or attached gingival) reconstruction in the implant restoration can effectively reduce the incidence of gingivitis,reconstruct the width of keratinized gingival in the edentulous area,improve the red aesthetics,providing a stable soft tissue environment for the implant to obtain a good repair effect finally.