根向复位瓣技术重建对上颌后牙种植牙颊侧角化龈牙周指数的影响

Effect of root reduction flap reconstruction on the periodontal index of buccal keratinized gingiva in maxillary posterior implants

目的:探究根向复位瓣(Apically repositioned flap,ARF)技术重建对上颌后牙种植牙颊侧角化龈(Keratinized gingiva,KG)牙周指数的影响。方法:选取我院96例上颌后牙种植牙颊侧KG狭窄或缺失患者(2019年1月~2021年3月),进行前瞻性随机平行对照研究,按随机数字表法分成A组(n=48)、B组(n=48)。B组通过常规种植方法治疗,A组通过ARF技术重建治疗。对比两组手术效果、术前与术后30d KG宽度和厚度、牙周指数[菌斑指数(Plaque index,PLI)、牙龈指数(Gingival index,GI)]、血清肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素1β(Interleukin-1β,IL-1β)水平及患者满意度。结果:术后30 d,A组总有效率、总满意度较B组高,KG宽度、厚度较B组优,GI、PLI评分及血清TNF-α、IL-1β水平较B组低(P<0.05)。结论:上颌后牙种植牙颊侧KG狭窄或缺失患者应用ARF技术重建治疗效果显著,可有效改善牙周指数,促进KG厚度、宽度恢复,缓解炎性反应,提升患者满意度。

Objective:To investigate the effect of apically repositioned flap(ARF)reconstruction on the periodontal index of Keratinized gingiva(KG)implanted in maxillary posterior teeth.Methods:A total of 96 patients with buccal KG stenosis or loss of maxillary posterior dental implant in our hospital from January 2019 to March 2021 were selected for a prospective randomized parallel control study,and were divided into group A(n=48)and group B(n=48)according to random number table method.Group B was treated with conventional implantation,and group A was treated with ARF reconstruction.The surgical results,preoperative and 30d after operation′KG width and thickness,periodontal index[Plaque index(PLI),Gingival index(GI)],serum Tumor necrosis factor-α,(TNF-α),interleukin-1β(IL-1β)levels,satisfaction were compared between the two groups.Results:30d after operation,the total effective rate and total satisfaction rate of group A were higher than that of group B,the KG width and thickness were better than that of group B,the GI,PLI scores and serum TNF-αand IL-1β levels were lower than that of group B(P<0.05).Conclusion:ARF technique can effectively improve periodontal index,promote the recovery of KG thickness and width,relieve inflammatory response,and improve patient satisfaction in patients with buccal KG stenosis or loss of maxillary posterior implants.