游离龈移植术对种植体附着龈过窄患者附着龈宽度及牙周指标的影响

Effect of Free Gingival Graft on Attached Gingival Width and Periodontal Indicators in Patients with Narrow Implant-Attached Gingiva

目的探究游离龈移植术对种植体附着龈过窄患者附着龈宽度及牙周指标的影响。方法回顾2020年4月至2022年9月郑州大学第一附属医院收治的90例种植体附着龈过窄患者资料,根据治疗方法分为观察组(47例)和对照组(43例),其中观察组接受游离龈移植术治疗,对照组接受根向复位瓣术治疗。比较术毕即时、术后1、3、7 d疼痛[视觉模拟评分法(VAS)]差异,术毕即时、术后7 d、1个月的出血指数、牙龈指数差异,术后6个月的疗效差异,术前、术后1个月、3个月、6个月的附着龈宽度、牙周探诊深度、菌斑指数差异。结果观察组术毕即时、术后1、3、7 d时VAS得分高于对照组,差异有统计学意义(P<0.05);两组术毕即时、术后7 d的出血指数、牙龈指数比较,差异无统计学意义(P>0.05),观察组术后1个月出血指数、牙龈指数低于对照组,差异有统计学意义(P<0.05);观察组术后1个月、术后3个月、6个月时的附着龈宽度大于对照组,牙周探诊深度小于对照组,差异有统计学意义(P<0.05),两组术后1个月、术后3个月、6个月时的菌斑指数比较,差异无统计学意义(P>0.05);观察组术后6个月治疗总有效性高于对照组,差异有统计学意义(P<0.05)。结论使用游离龈移植术治疗种植体附着龈过窄患者虽然术后短期疼痛明显,但可更有效增加附着龈宽度,疗效更佳。

Objective To explore the effect of free gingival graft on the attached gingival width and periodontal indicators in patients with narrow implant-attached gingiva.Methods The data of 90 patients with narrow implant-attached gingiva admitted in the First Affiliated Hospital of Zhengzhou University from April 2020 to September 2022 were reviewed and the patients were divided into observation group(47 cases)and control group(43 cases)according to the treatment methods.The observation group received free gingival graft and the control group adopted apically repositioned flap surgery.The differences in pain[Visual Analogue Scale(VAS)]immediately after the end of surgery and at 1 day,3 days and 7 days after surgery,bleeding index and gingival index immediately after the end of surgery and at 7 days and 1 month after surgery,efficacy at 6 months after surgery,attached gingival width,periodontal probing depth and plaque index before treatment and after 1 month,3 months and 6 months of treatment were compared.Results VAS scores in observation group immediately after the end of surgery and at 1,3 and 7 days after surgery were higher than those in control group,with significant differences(P<0.05).There were no statistically significant differences in bleeding index and gingival index between the two groups immediately after the end of surgery and at 7 days after surgery(P>0.05).The bleeding index and gingival index in observation group were lower than those in control group at 1 month after surgery,with significant differences(P<0.05).At 1 month,3 months and 6 months after surgery,the attached gingival width in observation group were wider than those in control group,and the periodontal probing depth were lower than those in control group,with significant differences(P<0.05).There were no statistical differences in the plaque index between both groups after 1 month,3 months and 6 months after surgery(P>0.05).The total effectiveness of treatment in observation group was higher than that in control group at 6 months after surgery,with significant difference(P<0.05).Conclusions Although free gingival graft has obvious postoperative short-term pain,it can effectively increase the attached gingival width and has good efficacy.