Fortin Thomas, Bosson Jean Luc, Isidori Michel, Blanchet Eric
Department of Oral Surgery, Dental University of Lyon, France.
Int J Oral Maxillofac Implants. 2006 Mar-Apr;21(2):298-304.
The aim of this study was to compare the pain experienced after implant placement with 2 different surgical procedures: a flapless surgical procedure using an image-guided system based on a template and an open-flap procedure.
The study population consisted of 60 patients who were referred for implant placement. One group consisted of 30 patients who were referred for the placement of 80 implants and treated with a flapless procedure. The other group consisted of 30 patients who were referred for the placement of 72 implants with a conventional procedure. Patients were selected randomly. They were requested to fill out a questionnaire using a visual analog scale (VAS) to assess the pain experienced and to indicate the number of analgesic tablets taken every postoperative day from the day of the surgery (DO) to 6 days after surgery (D6).
The results showed a significant difference in pain measurements, with higher scores on the VAS with open-flap surgery (P < .01). Pain decreased faster with the flapless procedure (P = .05). The number of patients who felt no pain (VAS = 0) was higher with the flapless procedure (43% at DO versus 20%). With the flapless procedure, patients took fewer pain tablets (P = .03) and the number of tablets taken decreased faster (P = .04).
Minimally invasive procedures may be requested by patients to reduce their anxiety and the pain experienced and thus increase the treatment acceptance rate.
With the flapless procedure, patients experienced pain less intensely and for shorter periods of time.
本研究的目的是比较采用两种不同手术方法植入种植体后所经历的疼痛：一种是基于模板的图像引导系统的无瓣手术方法，另一种是翻瓣手术。
研究人群包括60名因种植体植入前来就诊的患者。一组由30名因植入80颗种植体前来就诊并接受无瓣手术治疗的患者组成。另一组由30名因植入72颗种植体前来就诊并接受传统手术的患者组成。患者是随机选择的。要求他们使用视觉模拟量表（VAS）填写问卷，以评估所经历的疼痛，并指出从手术当天（DO）到术后6天（D6）每天服用的止痛片数量。
结果显示疼痛测量存在显著差异，翻瓣手术的VAS评分更高（P <.01）。无瓣手术疼痛缓解更快（P =.05）。无瓣手术中无疼痛（VAS = 0）的患者数量更多（DO时为43%，而翻瓣手术为20%）。采用无瓣手术时，患者服用的止痛片更少（P =.03），且服用的止痛片数量下降更快（P =.04）。
患者可能会要求采用微创手术来减轻焦虑和所经历的疼痛，从而提高治疗接受率。
采用无瓣手术时，患者经历的疼痛程度更低，持续时间更短。
