上前牙区牙龈瘤切除同期美学修复的疗效评价

Evaluation of the effects of simultaneous resection and aesthetic restoration for epulis resection of upper anterior region

目的:评估上前牙区牙龈瘤切除同期行美学修复较传统术式的优势。方法:收集40例牙龈瘤患者,随机分为传统手术组(传统组)和美学修复组(美学组)(n=20)。传统组仅行牙龈瘤切除。美学组牙龈瘤切除同期采用带蒂瓣(冠向复位瓣或侧向转位瓣)行美学修复。术中、术后2周、3个月、6个月记录纳入位点的角化龈宽度(KGW)、牙龈退缩(GR)、红色美学指数(PES)。术后2周、6个月记录患者满意度及龈瘤复发情况。结果:术后2周、3个月、6个月美学组KGW显著高于传统组,GR显著低于传统组。术后2周、3个月PES美学组显著高于传统组(P<0.05)。术后2周、6个月美学组患者满意度更高(P<0.05)。术后6个月两组均无牙龈瘤复发。结论:牙龈瘤切除同期采用带蒂瓣修复可显著改善角化组织量和美学效果。

Objective: To evaluate the advantages of simultaneous aesthetic repair following epulis resection in the upper anterior region. Methods: 40 patients with epulis were randomly divided into 2 groups(n=20). The patients in traditional operation group(traditional group) were treated by conventional operation, those in the aesthetic repair group(aesthetic group) were treated by epulis resection followed by pedicle flap(coronally advanced flap or lateral sliding flap) restoration. The keratinized gingival width(KGW), gingival recession(GR) and red aesthetic index(PES) of the inclusion sites were examined and recorded during the operation, 2 weeks, 3 and 6 months after the operation. Patients’ satisfaction degree was recorded 2 weeks after operation, and the satisfaction degree and relapse of epulis were recorded 6 months after operation. The data were analyzed with SPSS 22.0 statistical software. Results: 2 weeks, 3 and 6 months after operation, KGW in aesthetic group was more than that in traditional group(P<0.05), GR was less than that in traditional group(P<0.05). 2 weeks and 3 months after operation, PES of aesthetics group was higher than the traditional group(P<0.05). 2 weeks and 6 months after operation, the satisfaction of aesthetic group was higher than that of traditional group(P<0.05). Conclusion: After the epulis resection, the pedicled flap(coronal or lateral repositioning flap) may be used to cover the exposed bone surface and root surface, sufficient keratinized tissue and ideal aesthetic effect can be obtained.