Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Corso Giovecca 203, 44100, Ferrara, Italy.
Clin Oral Investig. 2013 Jul;17(6):1573-83. doi: 10.1007/s00784-012-0838-6. Epub 2012 Sep 9.
This study aims to evaluate the early postoperative healing of papillary incision wounds and its association with (1) patient/site-related factors and technical (surgical) aspects as well as with (2) 6-month clinical outcomes following buccal single flap approach (SFA) in the treatment of intraosseous periodontal defects.
Forty-three intraosseous defects in 35 patients were accessed with a buccal SFA alone or in combination with a reconstructive technology (graft, enamel matrix derivative (EMD), graft + EMD, or graft + membrane). Postoperative healing was evaluated at 2 weeks using the Early Wound-Healing Index (EHI).
EHI ranged from score 1 (i.e., complete flap closure and optimal healing) to score 4 (i.e., loss of primary closure and partial tissue necrosis). SFA resulted in a complete wound closure at 2 weeks in the great majority of sites. A significantly more frequent presence of interdental contact point and interdental soft tissue crater, and narrower base of the interdental papilla were observed at sites with either EHI > 1 or EHI = 4 compared to sites with EHI = 1. No association between EHI and the 6-month clinical outcomes was observed.
At 2 weeks, buccal SFA may result in highly predictable complete flap closure.
Site-specific characteristics may influence the early postoperative healing of the papillary incision following SFA procedure. Two-week soft tissue healing, however, was not associated with the 6-month clinical outcomes.
本研究旨在评估牙间乳头切口的早期术后愈合情况,并探讨其与(1)患者/部位相关因素和技术(手术)方面以及(2)颊侧单瓣法(SFA)治疗骨内牙周缺损 6 个月临床疗效的关系。
采用颊侧 SFA 单独或联合重建技术(植骨、釉基质衍生物(EMD)、植骨+EMD、植骨+膜)治疗 35 例患者的 43 个骨内缺损。术后 2 周采用早期伤口愈合指数(EHI)评估愈合情况。
EHI 评分范围为 1 分(即完全瓣封闭和最佳愈合)至 4 分(即丧失一期愈合和部分组织坏死)。SFA 可使绝大多数部位在 2 周内完全封闭伤口。与 EHI=1 的部位相比,EHI>1 或 EHI=4 的部位存在更多的牙间接触点和牙间软组织凹陷,以及更窄的牙间乳头基底。EHI 与 6 个月临床疗效之间无相关性。
术后 2 周,颊侧 SFA 可能导致高度可预测的完全瓣封闭。
特定部位的特征可能影响 SFA 术后牙间乳头切口的早期愈合。然而,两周时的软组织愈合与 6 个月的临床疗效无关。