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[胶原蛋白基质与游离龈瓣移植术在增加牙种植体周围角化黏膜方面的短期临床疗效]

[Short-term clinical efficacy of a collagen matrix and free gingival graft in augmenting keratinized mucosa around dental implants].

作者信息

Wang Q, Meng H X, Song W L, Li W J, Shi S W, Hou J X, Han J

机构信息

Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2019 Feb 9;54(2):79-86. doi: 10.3760/cma.j.issn.1002-0098.2019.02.002.

Abstract

To compare the short-term outcomes of a collagen matrix (CM) and free gingival graft (FGG) in augmenting keratinized mucosa around dental implants. Nineteen partially edentulous patients who had undergone implant surgery or implant review from June 2017 to June 2018 at Department of Periodontology, Peking University School and Hospital of Stomatology with lack of keratinized mucosa at buccal aspect of implants (<2 mm) were recruited in this study. According to the width of keratinized mucosa (KW) pre-operation, 9 patients including 5 males and 4 females were assigned into control group (KW<0.5 mm) which performed free gingival graft (17 implants) and 10 patients including 3 males and 7 females were assigned into experimental group (KW≥0.5 mm) which used collagen matrix as the grafts (15 implants). The KW at buccal aspect of each implant were measured pre-operation and 2 weeks, 1 month, 2 months, 3 months after surgery respectively. Each of the patients was required to fill out a questionnaire using a visual analogue scale to assess the postoperative morbidity. The KWs around implants were increased significantly during the 3 months follow-up period in both groups (0.01). At 3 months after surgery, KW gain in control group was (3.44±1.64) mm, in experimental group was (2.30±0.82) mm, the difference between two groups was statistically significant (0.05). Meantime, the total shrinkage of KW in control group [(34±25)%] and experimental group [(51±11)%] also showed a statistically significant difference (0.01). However, by using collagen matrix as the grafts, augmented tissues had a much more comparable appearance with adjacent tissues than that in control group. And the patients of experimental group experienced much less postoperative bleeding than those of control group. Both collagen matrix and free gingival graft can significantly increase the KW around implants within the 3 months post-surgery follow-up period. There were more KW gain and less shrinkage in group FGG than that in group CM. However, surgery time were reduced and the postoperative bleeding were less in group CM than in group FGG as no harvesting procedure was needed.

摘要

比较胶原基质(CM)和游离龈瓣移植术(FGG)在增加牙种植体周围角化黏膜方面的短期效果。本研究招募了19例部分牙列缺损患者,这些患者于2017年6月至2018年6月在北京大学口腔医学院牙周科接受了种植手术或种植复诊,其种植体颊侧角化黏膜不足(<2mm)。根据术前角化黏膜宽度(KW),将9例患者(5例男性,4例女性)分为对照组(KW<0.5mm),行游离龈瓣移植术(17枚种植体);10例患者(3例男性,7例女性)分为试验组(KW≥0.5mm),使用胶原基质作为移植材料(15枚种植体)。分别在术前、术后2周、1个月、2个月、3个月测量各种植体颊侧的KW。要求每位患者使用视觉模拟量表填写问卷,以评估术后不适情况。两组在3个月的随访期内,种植体周围的KW均显著增加(P<0.01)。术后3个月,对照组KW增加量为(3.44±1.64)mm,试验组为(2.30±0.82)mm,两组差异有统计学意义(P<0.05)。同时,对照组KW的总收缩率[(34±25)%]和试验组[(51±11)%]也有统计学意义(P<0.01)。然而,使用胶原基质作为移植材料时,增生组织与相邻组织的外观比对照组更相似。试验组患者术后出血比对照组少。胶原基质和游离龈瓣移植术均可在术后3个月的随访期内显著增加种植体周围的KW。FGG组的KW增加量更多,收缩率更小。然而,CM组由于无需采集过程,手术时间缩短,术后出血也更少。

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