局部带蒂黏膜附着龈重建术和游离龈移植术在口腔种植修复中的疗效

Efficacy of local mucosal pedicled flaps for attached gingival reconstruction versus free gingival grafting in oral implant repair

目的探讨局部带蒂黏膜附着龈重建术和游离龈移植术在口腔种植修复中的临床疗效。方法回顾性分析2018年10月至2020年10月收治的92例口腔种植修复患者的病案资料,根据手术治疗方式选择情况的不同,分为重建组(n=46,采取局部带蒂黏膜附着龈重建术)和游离组(n=46,采取游离龈移植术)。评价2种治疗方式的临床效果,比较2组手术前后的菌斑指数、视觉模拟评分(VAS)、出血指数、角化龈宽度。结果2组口腔种植修复患者的种植成功率比较,差异无统计学意义(P>0.05)。重建组术后3、6个月菌斑指数,术后1周VAS评分,术后3个月出血指数与游离组,差异无统计学意义(P>0.05);2组术后菌斑指数、VAS评分、出血指数较术前均显著下降(P<0.05)。重建组术后3、6个月的角化龈宽度低于游离组(P<0.05)。结论局部带蒂黏膜附着龈重建术和游离龈移植术在口腔移植修复中均能达到显著效果,利于种植牙移植固定,且术后菌斑指数、VAS评分、出血指数均显著下降,但后者角化龈宽度移植效果更显著,两种术式各有优劣势,应结合患者具体病情合理选择适宜术式。

Objective To investigate the efficacy of local mucosal pedicled flaps for attached gingival reconstruction versus free gingival grafting in oral implant repair.Methods The medical records of 92 patients with oral implant restoration admitted to our hospital from October 2018 to October 2020 were retrospectively analyzed.According to the selection of surgical treatment methods,they were divided into reconstruction group(n=46 cases,local mucosal pedicled flaps for attached gingival reconstruction)and free group(n=46 cases,free gingival grafting).The clinical effects of the two treatments were evaluated,and the plaque index,the Visual Analogue Scale(VAS)score,bleeding index and keratinized gingival width were compared between the two groups before and after surgery.Results There was no significant difference in the success rate of implantation between groups(P>0.05).No significant differences were detected in the plaque index at 3 and 6 months after surgery,the VAS score at 1 week after surgery,and the bleeding index at 3 months after surgery were detected between groups(P>0.05).After surgery,the plaque index,VAS score and bleeding indexes in both groups were significantly reduced(P<0.05).The keratinized gingiva width at 3 and 6 months after surgery in the reconstruction group was significantly lower than that of the free group(P<0.05).Conclusion Both local mucosal pedicled flaps for attached gingival reconstruction and free gingival grafting can achieve significant results in oral transplantation and repair,which is beneficial to implant fixation,lowering postoperative plaque index,VAS score and bleeding index,but the latteRhas a more significant effect on keratinized gingival width transplantation.The two procedures have their own advantages and disadvantages,and the appropriate surgery should be reasonably selected according to the specific conditions of patients.