Jané-Salas Enric, Roselló-LLabrés Xavier, Jané-Pallí Enric, Mishra Siddharth, Ayuso-Montero Raúl, López-López José
Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
Oral Medicine Unit, Faculty of Medicine and Health Sciences (Dentistry), Dental Hospital University of Barcelona, Barcelona University, Barcelona, Spain.
Odontology. 2018 Jul;106(3):340-348. doi: 10.1007/s10266-018-0343-8. Epub 2018 Feb 20.
The aim of this study was to compare the immediate postoperative period of participants rehabilitated with dental implants placed with a conventional technique or with a minimally invasive technique, without a mucoperiosteal flap elevation (flapless). Participants who needed implant placement were divided into two groups: one group was operated using a mucoperiosteal flap elevation (G_A), and the other with a flapless surgical technique (G_B). Objective clinical parameters including oral hygiene, mouth opening, inflammation (facial perimeter), surgical time and analgesic consumption, as well as subjective parameters of pain and degree of satisfaction with the procedure, were evaluated. 48 implants were placed in 30 participants (15 participants per group). Oral hygiene index, maximum interincisal opening, pain and analgesic consumption values had a significant difference between groups favoring the flapless technique at 24 h and 7 days but at the 15 days' follow-up the differences were only significant for oral hygiene and pain (P < 0.05); there were no statistically significant differences between groups in terms of facial perimeter values and surgical time (P > 0.05). Average on the degree of satisfaction was of 2.6 (SD 0.8) for G_A and 3.6 (SD 1.02) for G_B (P = 0.06). One implant placed in G_A (2.0%) failed before prosthetic loading due to mobility and pain at 3 months' follow-up. Participants operated for implant placement with flapless surgical technique go through less postoperative discomfort. Both techniques show high success rates, but to perform a flapless technique patients must be properly selected.
本研究的目的是比较采用传统技术或微创技术（不掀起黏骨膜瓣，即无瓣技术）植入牙种植体的参与者术后即刻阶段的情况。需要植入种植体的参与者被分为两组：一组采用掀起黏骨膜瓣的手术方式（A组），另一组采用无瓣手术技术（B组）。评估了包括口腔卫生、开口度、炎症（面部周长）、手术时间和镇痛药物用量等客观临床参数，以及疼痛的主观参数和对手术的满意度。30名参与者共植入48枚种植体（每组15名参与者）。在术后24小时和7天时，两组之间的口腔卫生指数、最大切牙间开口度、疼痛和镇痛药物用量值存在显著差异，无瓣技术更具优势，但在15天随访时，仅口腔卫生和疼痛方面的差异具有统计学意义（P<0.05）；两组在面部周长值和手术时间方面无统计学显著差异（P>0.05）。A组的满意度平均为2.6（标准差0.8），B组为3.6（标准差1.02）（P = 0.06）。A组植入的一枚种植体（2.0%）在3个月随访时因松动和疼痛在修复加载前失败。采用无瓣手术技术植入种植体的参与者术后不适较少。两种技术均显示出高成功率，但要实施无瓣技术，必须对患者进行适当选择。
