改良侧向转位冠向复位瓣联合结缔组织移植治疗单牙重度MillerⅡ类或MillerⅢ类牙龈退缩的疗效评价

Evaluation of the efficacy of modified laterally to coronal repositioning aps combined with connective tissue transplantation in the treatment of severe Miller classⅡ/classⅢgingival recession in single teeth

目的探讨改良侧向转位冠向复位瓣联合结缔组织移植(CTG)治疗单牙重度MillerⅡ类或MillerⅢ类牙龈退缩患者的疗效。方法选取牙周病科就诊且治疗的单牙重度牙龈退缩患者61例为研究对象,对照组(30例)采取侧向转位冠向复位瓣联合CTG治疗,观察组(31例)采用改良侧向转位冠向复位瓣联合CTG治疗,比较2组患者的牙周指标、美学效果、患者自主满意程度以及术后自主疼痛评分。结果治疗前2组牙周指标比较,差异无统计学意义(P>0.05),半年后复诊2组比较KTH、RD、CAL、RC差异有统计学意义(P<0.05),PD差异无统计学意义(P>0.05);治疗前2组的PES、WES以及自主满意程度评分VAS无明显差异(P>0.05),半年后复诊观察组的PES、WES以及VAS均高于对照组(P<0.05);术后2周复诊,患者应用VAS进行主观疼痛评分,2组评分比较差异均无统计学意义(P>0.05)。结论改良侧向转位冠向复位瓣联合CTG不但可以改善患者的牙龈状态,也能改善美学效果,提高患者满意度。

Objective To explore the efficacy of modified lateral transposition coronal repositioning flap combined with connective tissue grafting(CTG)in the treatment of patients with severe Miller Class II or Miller Class III gingival recession in a single tooth.Methods A total of 61 patients with severe gingival recession of single tooth were selected as the research object.The control group was treated with lateral transposition of coronal reduction flap combined with CTG(n=30),and the observation group was treated with improved lateral transposition of coronal reduction flap combined with CTG(n=31).The periodontal index,aesthetic effect,patient′s autonomous satisfaction and postoperative independent pain scores of the two groups were compared.Results Before treatment,there was no statistical difference in periodontal indexes between the two groups(P>0.05),and after six months′following-up,there was a statistically significant difference in KTH,RD,CAL and RC between the two groups(P<0.05),while there was no statistical difference in PD(P>0.05).There was no significant difference in PES,WES and VAS scores of self-satisfaction between the two groups before the treatment(P>0.05).After six months of follow-up,PES,WES and VAS of the observation group were higher than those of the control group(P<0.05).There was no significant difference between the two groups in subjective pain score by VAS in 2 weeks after operation(P>0.05).Conclusion Modified lateral transposition coronal reduction flap combined with CTG can not only improve the gingival status of patients,but also improve the aesthetic effect and patient satisfaction.