软组织移植用于治疗正畸后牙龈退缩的临床疗效分析

Clinical Study on Effect of Soft Tissue Graft on Gingival Recession after Orthodontic Treatment

目的:用软组织移植的方法治疗正畸后牙龈退缩,通过统计相关临床指标来评估软组织移植治疗正畸治疗后牙龈退缩的临床效果。方法:收集正畸治疗后发生牙龈退缩的患者12例,均为MillerⅠ类、MillerⅡ类牙龈退缩,采用冠向复位瓣+结缔组织移植或游离龈移植的方法治疗牙龈退缩,在基线和术后1年随访时分别记录每颗牙牙龈退缩深度(RD)、角化龈宽度(KTW)、根面覆盖率(RC),探诊深度(PD),采用视觉模拟评分法(VAS)评估患者对手术的满意度,计算各项临床指标平均值变化。结果:12例患者的平均基线RD为(3.7±0.9)mm,术后1年平均RD为(0.3±0.9)mm;术后1年患者的平均RC为(97.1±6.3)%,大部分牙齿得到完全根面覆盖;患者基线和术后1年平均KTW为(0.8±0.3)mm和(3.8±0.6)mm,角化龈增加明显;PD从基线(1.5±0.5)mm减少到(1.2±0.5)mm;术后1年患者满意度评分为(9.6±0.6)分,大部分患者对术后效果感到满意且根面敏感情况好转。结论:正畸治疗后牙龈退缩的患者采用冠向复位瓣+结缔组织移植或游离龈移植的方法均可取得良好临床效果,患者根面敏感情况得到明显改善且满意度高。

Objective:To evaluate the clinical outcomes of treatment of gingival recession after orthodontic treatment with soft tissue graft.Methods:Twelve patients with gingival recession after orthodontic treatment were treated with coronal advanced flap combined with connective tissue graft(CAF+CTG)or free gingival graft(FGG).Recession depth(RD),keratinized tissue width(KTW),pocket depth(PD),and root coverage rate(RC)at baseline and follow-up-one-year after treatment were recorded and analyzed.The satisfaction degree of patients was evaluated by visual analogue scale(VAS).Results:The mean RDs and KTWs at baseline and follow-up were(3.7±0.9)mm,(0.8±0.3)mm,(0.3±0.9)mm,and(3.8±0.6)mm,respectively.The mean RC at follow-up was(97.1±6.3)%.PD was decreased from(1.5±0.5)mm to(1.2±0.5)mm.The VAS value was 9.6±0.6 at oneyear-follow-up.Root sensitivity was significantly improved.Conclusion:The coronal advanced flap combined with connective tissue graft(CAF+CTG)or free gingival graft(FGG)has ideal clinical outcomes and satisfaction for the treatment of gingival recession after orthodontic treatment.