下颌后牙区“香肠技术”植骨后颊侧角化龈宽度的临床观察

Clinical observation of buccal keratinized gingival width of "sausage technique" in mandibular posterior area

目的探讨下颌后牙区"香肠技术"植骨后颊侧角化龈宽度的变化及其与植骨量的相关性,并评价颊侧角化龈宽度不足患者进行游离龈移植术后的临床效果。方法选择2019年4月至2020年9月在大连市口腔医院种植科因牙列缺损行下颌后牙区"香肠技术"植骨后种植修复患者24例。测量所有患者植骨前后的颊侧角化龈宽度以及植骨后当天植骨量,对植骨前后的角化龈宽度进行比较,并分析植骨后角化龈宽度变化与植骨量的相关性。对植骨后6个月颊侧角化龈宽度不足2 mm的患者进行腭部游离龈移植术,移植术后3个月复查,对获得的种植体颊侧角化龈宽度、龈瓣收缩率进行观察和评价。结果24例患者平均植骨量为(629.30±226.42)mm^(3),植骨后角化龈宽度平均减少量为(1.15±0.82)mm,植骨量与角化龈宽度减少量呈正相关。12例进行游离龈移植术患者的术后角化龈宽度增加,移植术后3个月龈瓣收缩率为(22.89±2.85)%。结论"香肠技术"植骨术后角化龈宽度有所减小,与植骨量呈正相关,游离龈移植后龈瓣收缩较少,可显著增加种植体周围角化龈宽度。

Objective To explore the change in buccal keratinized gingival width after bone grafting in the posterior mandibular area with "sausage technique" and its correlation with the amount of bone graft,and to evaluate the clinical effect of free gingival transplantation in patients with insufficient buccal keratinized gingival width.Methods Totally 24 patients were selected to undergo implant restoration after bone grafting with "sausage technique" in the posterior mandibular area due to dentition defects.Measure the buccal keratinized gingival width before and after bone grafting and the amount of bone grafted on the day after bone grafting in all patients,compare the keratinized gingival width before and after bone grafting,and analyze the correlation between the change in keratinized gingival width after bone grafting and the amount of bone grafting.The patients whose buccal keratinized width after bone grafting was less than 2 mm underwent free gingival flap transplantation of palatine.Reexamination was performed 3 months after the operation,and the buccal keratinized width of the implant obtained and the contraction rate of gingival flap were observed and assessed.Results The average bone graft volume of 24 patients was(629.30 ± 226.42)mm;,and the average reduction of keratinized gingival width after bone grafting was(1.15 ± 0.82)mm.The bone graft volume was positively correlated with the reduction of keratinized gingival width.The postoperative keratinized gingival width of 12 patients undergoing free gingival transplantation increased,and the 3-month contraction rate of the gingival flap graft was(22.89 ± 2.85)%.Conclusion The width of keratinized gingiva after"sausage technique"bone grafting is reduced,which is positively correlated with the amount of bone graft.After free gingival transplantation,the gingival flap shrinks less,which can significantly increase the width of keratinized gingiva around the implant.