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新型骨膜瓣拉伸技术:一种在增量手术中实现并维持一期缝合的可预测方法。

The Novel Periosteal Flap Stretch Technique: A Predictable Method to Achieve and maintain Primary Closure in Augmentative Procedures.

作者信息

Abed Pooria Fallah, El Chaar Edgard, Boltchi Farhad, Bassir Seyed Hossein

机构信息

Department of Periodontology, Texas A and M College of Dentistry, Dallas, TX, USA.

Department of Periodontology, School of Dentistry, New York, NY. USA.

出版信息

J Int Acad Periodontol. 2020 Jan 1;22(1):11-20.

Abstract

BACKGROUND

Correct soft tissue management and achieving tension-free primary closure are pre-requisites for the success of bone augmentation procedures. Several techniques have been developed to facilitate a passive soft tissue primary closure. However, the current techniques are highly invasive and require advanced surgical skills. Hence, the present case series report will describe a novel and simple flap management technique.

METHODS

The Periosteal Flap Stretch technique was utilized in bone augmentation procedures for four patients who presented with horizontal and vertical alveolar ridge deficiencies in the anterior maxilla, anterior mandible, posterior mandible, and posterior maxilla. This technique is performed using a blunt surgical curette that engages the periosteum of the mucosa below the mucogingival line of the full-thickness flap and stretches the periosteum in a coronal and outward direction, which results in stretching of the flap without the need for vertical or periosteal releasing incisions.

RESULTS

Healing was uneventful for four all cases. No membrane exposure, no soft tissue dehiscence, or any other complications were observed during the six-months healing period after the respective bone augmentation procedures of cases.

CONCLUSIONS

The Periosteal Flap Stretch technique is a novel and simple technique that facilities achieving passive and predictable primary soft tissue closure.

摘要

背景

正确的软组织处理和实现无张力一期缝合是骨增量手术成功的先决条件。已经开发了几种技术来促进被动软组织一期缝合。然而,目前的技术具有高度侵入性,需要先进的手术技巧。因此,本病例系列报告将描述一种新颖且简单的皮瓣处理技术。

方法

对4例分别在前上颌骨、前下颌骨、后下颌骨和后上颌骨存在水平和垂直牙槽嵴缺损的患者,在骨增量手术中采用骨膜瓣拉伸技术。该技术使用钝性手术刮匙,使其与全厚皮瓣龈黏膜线下方黏膜的骨膜接触,并沿冠状和向外方向拉伸骨膜,从而在无需垂直或骨膜松解切口的情况下实现皮瓣拉伸。

结果

所有4例患者愈合均顺利。在各病例进行骨增量手术后的6个月愈合期内,未观察到膜暴露、软组织裂开或任何其他并发症。

结论

骨膜瓣拉伸技术是一种新颖且简单的技术,有助于实现被动且可预测的一期软组织闭合。

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