Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary.
Department of Periodontology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary.
Oral Dis. 2019 Oct;25(7):1780-1788. doi: 10.1111/odi.13163. Epub 2019 Aug 19.
The aim of the present study was to investigate temporal and spatial blood flow patterns following vestibuloplasty procedures using a collagen matrix (CM) to get an insight into the timing and direction of neovascularization in the CM.
Five patients were treated using a modified apically repositioned flap combined with a CM. Intraoral photographs and blood flow measurements by laser speckle contrast imaging were taken for 12 months. Thirty regions of interest in the graft and the surrounding mucosa were evaluated. The clinical parameters were assessed after 6 and 12 months. VEGF expression was analyzed in the wound fluid on days 2 and 4.
At 6 months, the mean width of keratinized gingiva increased, but the thickness was unchanged. Scar formation was observed in all cases. Perfusion in the graft began to increase at the lateral and coronal edges and then spread concentrically toward the center. The apical side showed a significant delay in perfusion, the highest VEGF expression, and wound fluid production as well as the most abundant scar formation.
Neovascularization occurs mainly from the lateral and coronal edges, which may limit the extent of the surgical area. Abundant scar formation may be explained by increased VEGF expression induced by prolonged ischemia in this area.
本研究旨在通过使用胶原蛋白基质（CM）研究前庭成形术后的时间和空间血流模式，以深入了解 CM 中的新生血管化的时间和方向。
对 5 名患者采用改良的根尖复位瓣联合 CM 进行治疗。在 12 个月内拍摄口腔内照片和激光散斑对比成像的血流测量。评估移植物和周围黏膜的 30 个感兴趣区域。在第 6 和第 12 个月后评估临床参数。在第 2 和第 4 天分析伤口液中的 VEGF 表达。
在 6 个月时，角化龈的平均宽度增加，但厚度不变。所有病例均出现瘢痕形成。移植物的灌注从侧面和冠部边缘开始增加，然后向中心同心扩散。顶端侧显示灌注明显延迟，VEGF 表达最高，伤口液产生最多，瘢痕形成最丰富。
新生血管化主要发生在侧面和冠部边缘，这可能限制了手术区域的范围。该区域缺血时间延长导致 VEGF 表达增加，可能解释了大量瘢痕形成的原因。
