Lazić Zoran, Golubović Mileta, Marković Aleksa, Šćepanović Miodrag, Mišić Tijana, Vlahović Zoran
Faculty of Medicine of the Military Medical Academy, University of Defense, Belgrade, Serbia.
Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
Clin Oral Implants Res. 2015 Jul;26(7):775-9. doi: 10.1111/clr.12337. Epub 2014 Jan 20.
The aim of this experimental study is to compare the effect of mini-incision flapless versus flap technique of implant placement on the amount of vascular structures and blood vessel elements in peri-implant soft tissue, using immunohistochemical analysis.
The experiment was conducted on five domestic pigs. Each animal received six implants in mandible according to the split-mouth design. On one randomly chosen jaw side, mini-incision flapless surgery was performed, whereas on the opposite jaw side, flap was raised. After 3 months of implant healing through submerged approach, the experimental animals were sacrificed and samples for immunohistochemical analyses were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The study outcome was the presence of vascular structures and elements of the blood vessels in the peri-implant mucosa per microscopic field, estimated through ordinal scores from 0 to 2. Effects of surgical approach, site of implantation, and their interaction on vascular scores of peri-implant mucosa were assessed by Brunner and Langer nonparametric analysis of longitudinal data.
Statistically significant effect of surgical approach on vascularity of peri-implant mucosa has been revealed in the second mucosal layer, where flapless approach provided higher vascularity compared with flap approach (P = 0.002). In the remaining two layers, surgical approach did not affect mucosal vascularity significantly (layer 1: P = 0.071; layer 3: P = 0.433).
The flapless surgical implant placement approach using mini-incision provides better vascularization of peri-implant mucosa after 3 months of healing compared with flap surgery.
本实验研究旨在通过免疫组织化学分析，比较微创无瓣与翻瓣种植技术对种植体周围软组织中血管结构和血管成分数量的影响。
对5头家猪进行实验。根据双侧对照设计，每只动物在下颌植入6枚种植体。在随机选择的一侧颌骨，采用微创无瓣手术，而在另一侧颌骨，则进行翻瓣手术。通过潜入式方法使种植体愈合3个月后，处死实验动物，并从种植体颈部旁的种植体周围黏膜颊侧三个水平采集样本进行免疫组织化学分析。研究结果是通过0至2的有序评分估计每个微观视野中种植体周围黏膜中血管结构和血管成分的存在情况。采用Brunner和Langer纵向数据非参数分析评估手术方式、种植部位及其相互作用对种植体周围黏膜血管评分的影响。
在第二层黏膜中，已揭示出手术方式对种植体周围黏膜血管化有统计学显著影响，其中无瓣手术方式相比翻瓣手术方式提供了更高的血管化程度（P = 0.002）。在其余两层中，手术方式对黏膜血管化没有显著影响（第1层：P = 0.071；第3层：P = 0.433）。
与翻瓣手术相比，采用微创切口的无瓣手术种植体植入方法在愈合3个月后能为种植体周围黏膜提供更好的血管化。
