Yadav Kirti, Dixit Jaya, Chhabra Apjit Kaur, Verma Umesh Pratap
Departments of Periodontology and Ophthalmology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India.
Natl J Maxillofac Surg. 2022 May-Aug;13(2):269-275. doi: 10.4103/njms.njms_408_21. Epub 2022 Jun 15.
Mucogingival surgery is performed to resolve the problems arising due to high frenum attachment and shallow vestibular depth (VD). The surgical procedures are mainly indicated to prevent gingival recession and for esthetic reasons. The aim of this study was to compare the degree of vascularization in the treatment of mucogingival problems by both microsurgical and macrosurgical techniques.
Forty-two participants with aberrant frenum and shallow VD were randomly selected for frenectomy, frenotomy, and vestibular deepening either by a microsurgical (test) or macrosurgical (control) approach. Fluorescein angiography was performed at 1, 7, and 14 days after the surgical procedures. In addition, patient's satisfaction scores were recorded postoperatively.
Angiographic evaluation at test site revealed a statistically significant vascularization at 1, 7, and 14 days after the surgical procedure when compared to control sites. Probing pocket depth(PPD) in both the groups in vestibular deepening procedure decreased from 1 month to 6 months, but the reduction was insignificant. There was significant reduction in VD in both the groups over a period of 6 months. Microsurgical approach in all three procedures was superior in terms of patient satisfaction than macrosurgical approach. Mean surgical time spent in vestibular deepening and frenectomy procedures was highly significant in micro group as compared to the macro group.
This clinical study indicates that microsurgical approach improved the percentage of vascularization and patient satisfaction compared with macrosurgical approach.
进行黏膜牙龈手术以解决由于系带附着过高和前庭深度（VD）浅而产生的问题。手术主要用于预防牙龈退缩和出于美观原因。本研究的目的是比较显微手术和宏观手术技术在治疗黏膜牙龈问题时的血管化程度。
随机选择42名有异常系带和浅VD的参与者，通过显微手术（试验组）或宏观手术（对照组）进行系带切除术、系带切开术和前庭加深术。在手术后1天、7天和14天进行荧光素血管造影。此外，术后记录患者的满意度评分。
与对照组相比，试验组手术部位的血管造影评估显示在手术后1天、7天和14天有统计学意义的血管化。在两组的前庭加深手术中，探诊袋深度（PPD）从1个月到6个月均下降，但下降不显著。在6个月的时间里，两组的VD均有显著下降。在所有三个手术中，显微手术方法在患者满意度方面优于宏观手术方法。与宏观组相比，微观组在前庭加深和系带切除术手术中花费的平均手术时间差异高度显著。
这项临床研究表明，与宏观手术方法相比，显微手术方法提高了血管化百分比和患者满意度。
