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用于软组织移植的结节与腭部供区:一项双侧对照临床研究。

Tuberosity versus palatal donor sites for soft tissue grafting: A split-mouth clinical study.

作者信息

Amin Peter N, Bissada Nabil F, Ricchetti Paul A, Silva Andre Paes B, Demko Catherine A

出版信息

Quintessence Int. 2018;49(7):589-598. doi: 10.3290/j.qi.a40510.

Abstract

OBJECTIVE

To compare postoperative pain associated with palatal and tuberosity donor sites for soft tissue grafting, and to evaluate the outcomes in both the donor and recipient sites.

METHOD AND MATERIALS

Twenty healthy nonsmokers requiring bilateral soft tissue grafts were recruited for the study. For the 10 patients who required free gingival graft (FGG), 10 epithelialized grafts were taken from the tuberosity and 10 from the palate. The other 10 patients who required coronally advanced flap (CAF) and connective tissue graft (CTG) received 10 de-epithelialized grafts from the tuberosity and 10 from the palate. A total of 20 receded areas were treated with CAF and CTG. A total of 20 mucogingival defects were treated by FGG. Pain level was reported by the patient using a subjective score on a scale of 0 to 10 (0 = no pain, 10 = very severe pain). The length, width, and thickness of the outcome was measured for the FGG group at 8 weeks. The percentage of root coverage along with the length, width, and thickness of the final outcome was measured for the FGG group as well as the CAF and CTG group.

RESULTS

Pain level in the tuberosity donor site was significantly lower than in the palatal donor site during the first 2 postoperative weeks (2.6 ± 2.16 versus 5.9 ± 2.74 respectively, P < .001). Mean gingival thickness of the healed tuberosity donor graft was greater than of the palatal donor grafts in both groups; for CAF and CTG group 2.9 ± 0.5 versus 2.3 ± 0.6 mm, respectively (P = .016); for FGG group 2.7 ± 0.7 versus 2.1 ± 0.7, respectively (P = .026). No differences were observed in the length or width of both grafted sites at an 8-week follow-up. No significant difference in the mean percentage of root coverage resulting from tuberosity or palatal donor sites was noted (67 ± 12% versus 62 ± 13%, respectively, P = .102).

CONCLUSION

Soft tissue grafts harvested from the tuberosity site might provide a better option than soft tissue donor grafts obtained from the palate in terms of function and less postoperative pain.

摘要

目的

比较用于软组织移植的腭部和结节供区术后疼痛情况,并评估供区和受区的治疗效果。

方法和材料

招募20名需要双侧软组织移植的健康非吸烟者进行本研究。对于10名需要游离龈瓣移植(FGG)的患者,从结节处获取10块上皮化移植物,从腭部获取10块。另外10名需要冠向推进瓣(CAF)和结缔组织移植(CTG)的患者,从结节处获取10块去上皮化移植物,从腭部获取10块。总共20个退缩区域接受了CAF和CTG治疗。总共20个膜龈缺损接受了FGG治疗。患者使用0至10分主观评分报告疼痛程度(0 = 无疼痛,10 = 非常严重疼痛)。在8周时测量FGG组治疗结果的长度、宽度和厚度。测量FGG组以及CAF和CTG组的牙根覆盖百分比以及最终治疗结果的长度、宽度和厚度。

结果

术后前2周,结节供区的疼痛程度显著低于腭部供区(分别为2.6±2.16和5.9±2.74,P <.001)。两组中,愈合后的结节供区移植物的平均牙龈厚度均大于腭部供区移植物;CAF和CTG组分别为2.9±0.5和2.3±0.6毫米(P = .016);FGG组分别为2.7±0.7和2.1±0.7(P = .026)。在8周随访时,两个移植部位的长度或宽度均未观察到差异。结节或腭部供区导致的牙根覆盖平均百分比无显著差异(分别为67±12%和62±13%,P = .102)。

结论

就功能和较少的术后疼痛而言,从结节部位获取的软组织移植物可能比从腭部获取的软组织供体移植物提供更好的选择。

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