School of Stomatology, Fujian Medical University, Fuzhou, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Mar;115(3):e21-7. doi: 10.1016/j.oooo.2011.11.025. Epub 2012 May 30.
The objective of this study was to compare soft tissue healing after implant placement in flap and flapless surgery in the dog model.
Mandibular premolars were extracted from 10 beagle dogs. The extraction sockets were allowed to heal for 8 weeks. After healing, 3 implants on each side of the mandible were implanted using either flap or flapless techniques. One implant was installed on each side at the 0-, 4-, and 6-week time point. Eight weeks later, the peri-implant soft tissue healing was subjected to clinical and immunohistochemical analysis.
It was revealed that vascular endothelial growth factor (VEGF) expression, peri-implant crevicular fluid (PICF) volume, and the aspartate aminotransferase and alkaline phosphatase activity in PICF increased significantly in the 2-week flap group compared with the 2-week flapless group. Microvascular density and VEGF expression in the 8-week flap group was statistically significantly lower than the 8-week flapless group and normal group. Buccal gingival recession was less pronounced in the flapless group than in the flap group after 4 and 8 weeks.
Within the limits of this study, the results demonstrate that flapless surgery contributes to better esthetic outcomes in implants compared with the flap approach.
本研究旨在比较犬模型中,在有瓣和无瓣手术中植入物放置后的软组织愈合情况。
从 10 只比格犬中拔除下颌前磨牙。拔牙窝愈合 8 周。愈合后,使用有瓣或无瓣技术在每侧下颌骨植入 3 个种植体。每个侧别在 0、4 和 6 周时间点各安装一个种植体。8 周后,对种植体周围软组织愈合情况进行临床和免疫组织化学分析。
结果表明,与无瓣组相比,有瓣组第 2 周的血管内皮生长因子(VEGF)表达、种植体周围龈沟液(PICF)量以及 PICF 中的天门冬氨酸氨基转移酶和碱性磷酸酶活性显著增加。有瓣组第 8 周的微血管密度和 VEGF 表达明显低于无瓣组和正常组。与有瓣组相比,无瓣组在 4 周和 8 周后颊侧牙龈退缩程度较轻。
在本研究范围内,结果表明与有瓣方法相比,无瓣手术有助于植入物获得更好的美学效果。