摘要
目的对比新型胶原基质与游离龈移植术增宽种植区域角化组织的短期临床效果,为两种方法的临床应用提供参考。方法纳入2017年6月至2018年6月于北京大学口腔医学院·口腔医院牙周科行种植修复治疗或种植术后复查且存在种植体颊侧角化组织宽度(the width of keratinized mucosa,KW)<2 mm的患者19例,共32枚种植体。根据术前种植体颊侧KW将患者分为试验组(KW≥0.5 mm)及对照组(KW<0.5 mm),试验组使用胶原基质、对照组采用游离龈移植术(free gingival graft,FGG)分别进行角化组织增量手术。试验组10例患者(3例男性,7例女性),15枚种植体;对照组9例患者(5例男性,4例女性),17枚种植体。术后2周及1、2、3个月复查,记录种植区域或种植体颊侧KW。同时要求患者在术后1周内每日填写术后出血、水肿及疼痛情况调查问卷,评分采用视觉模拟评分法(visual analogue scale,VAS)。结果试验组与对照组在术后3个月内与术前相比种植体颊侧KW均显著增宽(P<0.01),对照组角化组织增宽量(ΔKW)在术后2周及1、2、3个月均高于试验组,除术后2周外,其余时间点两组差异均有统计学意义(P<0.05)。术后3个月对照组ΔKW为(3.44±1.64)mm,试验组ΔKW为(2.30±0.82)mm。移植组织在术后均有不同程度收缩,术后2周内移植组织收缩最快,术后3个月时对照组与试验组的角化组织收缩率分别为(34±25)%和(51±11)%,两组差异有统计学意义(P<0.01)。两组术后水肿及疼痛VAS评分组间差异均无统计学意义,但试验组出血VAS评分[M(QR)][0.00(0.41)]显著低于对照组[0.50(1.09)](P<0.01)。术后3个月时试验组移植组织与邻近组织的颜色、质地基本一致,对照组的移植组织与邻近组织可以区分。结论新型胶原基质与游离龈移植术在术后3个月内均能增宽种植区域KW;游离龈移植术在角化组织增量的获得及移植组织收缩率方面均优于胶原基质;使用胶原基质进行角化组织增量手术能简化手术操作步骤,术后出血情况较轻,且移植区域的美学效果优于游离龈移植术。
ObjectiveTo compare the short-term outcomes of a collagen matrix (CM) and free gingival graft (FGG) in augmenting keratinized mucosa around dental implants.MethodsNineteen partially edentulous patients who had undergone implant surgery or implant review from June 2017 to June 2018 at Department of Periodontology, Peking University School and Hospital of Stomatology with lack of keratinized mucosa at buccal aspect of implants (<2 mm) were recruited in this study. According to the width of keratinized mucosa (KW) pre-operation, 9 patients including 5 males and 4 females were assigned into control group (KW<0.5 mm) which performed free gingival graft (17 implants) and 10 patients including 3 males and 7 females were assigned into experimental group (KW≥0.5 mm) which used collagen matrix as the grafts (15 implants). The KW at buccal aspect of each implant were measured pre-operation and 2 weeks, 1 month, 2 months, 3 months after surgery respectively. Each of the patients was required to fill out a questionnaire using a visual analogue scale to assess the postoperative morbidity.ResultsThe KWs around implants were increased significantly during the 3 months follow-up period in both groups (P<0.01). At 3 months after surgery, KW gain in control group was (3.44±1.64) mm, in experimental group was (2.30±0.82) mm, the difference between two groups was statistically significant (P<0.05). Meantime, the total shrinkage of KW in control group [(34±25)%] and experimental group [(51±11)%] also showed a statistically significant difference (P<0.01). However, by using collagen matrix as the grafts, augmented tissues had a much more comparable appearance with adjacent tissues than that in control group. And the patients of experimental group experienced much less postoperative bleeding than those of control group.ConclusionsBoth collagen matrix and free gingival graft can significantly increase the KW around implants within the 3 months post-surgery follow-up period. There were more KW gain and less shrinkage in group FGG than that in group CM. However, surgery time were reduced and the postoperative bleeding were less in group CM than in group FGG as no harvesting procedure was needed.
作者
王琪
孟焕新
宋文莉
李文静
石姝雯
侯建霞
韩劼
Wang Qi;Meng Huanxin;Song Wenli;Li Wenjing;Shi Shuwen;Hou Jianxia;Han Jie(Department of Periodontology,Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2019年第2期79-86,共8页
Chinese Journal of Stomatology
关键词
牙种植
角化组织
胶原基质
游离龈移植术
Dental implantation
Keratinized mucosa
Collagen matrix
Free gingival graft
作者简介
通信作者:韩劼,Email:han_jie17@sina.com,电话:010-82195372.
