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使用氰基丙烯酸酯和透明质酸组合处理去上皮化移植物采集后的腭部供区。

Cyanoacrylate and hyaluronic acid combination on palatal donor site management after de-epithelialized graft harvesting.

机构信息

Hacettepe University Faculty of Dentistry, Periodontology Department, Ankara, Turkey.

Private Practice, İzmir, Turkey.

出版信息

J Periodontol. 2023 Apr;94(4):519-528. doi: 10.1002/JPER.22-0409. Epub 2022 Nov 30.

DOI:10.1002/JPER.22-0409
PMID:36369975
Abstract

BACKGROUND

Although soft tissue substitutes showed promising improvement in the past decade, epithelialized gingival graft (EGG) is still widely used in periodontal plastic surgery applications. Donor site management after EGG harvesting has been challenging for clinicians. This study aimed to compare the effectiveness of cyanoacrylate, hyaluronic acid, and their combination in palatal donor site management after EGG harvesting.

METHODS

Data from 89 patients were included and categorized as gelatin sponge (GS), gelatin sponge with either cyanoacrylate (GS + CY), hyaluronic acid (GS + HA), or both (GS + CY + HA). The data of pain perception (PP), quantity of analgesics (QA), secondary bleeding (SB), epithelization level (EL), and color match (CM) were assessed retrospectively.

RESULTS

The GS + CY and GS + HA + CY groups showed lower PP scores compared to the GS and GS + HA groups (p < 0.05). The QA was higher in the GS group compared to the GS + CY and GS + HA + CY groups (p < 0.001). All study groups showed greater EL than GS group on day 7 (p < 0.001). On day 14, full EL was present in 81% of the patients in the GS + HA + CY group, which was higher than the other groups (p < 0.001). All study groups reported lower SB in the first 3 days, which was lower compared to the GS group (p < 0.001) and showed higher CM scores than the GS group on days 7 and 14 (p < 0.001).

CONCLUSIONS

CY application reduces pain and analgesic intake and HA may support the wound healing with increased EL. Using the CY-HA combination provides additional benefits for donor site management.

摘要

背景

尽管软组织替代物在过去十年中显示出了有前景的改善,但上皮化牙龈移植物(EGG)仍广泛应用于牙周整形手术中。EGG 采集后的供区管理一直是临床医生面临的挑战。本研究旨在比较氰基丙烯酸酯、透明质酸及其组合在 EGG 采集后腭部供区管理中的效果。

方法

共纳入 89 例患者的数据,并分为明胶海绵(GS)、GS 加氰基丙烯酸酯(GS+CY)、GS 加透明质酸(GS+HA)和 GS+CY+HA 组。回顾性评估疼痛感知(PP)、镇痛药用量(QA)、继发性出血(SB)、上皮化水平(EL)和颜色匹配(CM)。

结果

GS+CY 和 GS+HA+CY 组的 PP 评分低于 GS 和 GS+HA 组(p<0.05)。GS 组的 QA 高于 GS+CY 和 GS+HA+CY 组(p<0.001)。所有研究组在第 7 天的 EL 均大于 GS 组(p<0.001)。第 14 天,GS+HA+CY 组有 81%的患者达到完全上皮化,高于其他组(p<0.001)。所有研究组在第 1 至 3 天的 SB 较低,与 GS 组相比(p<0.001),且在第 7 和 14 天的 CM 评分高于 GS 组(p<0.001)。

结论

CY 应用可减轻疼痛和镇痛药的摄入,HA 可能通过增加 EL 来支持伤口愈合。使用 CY-HA 联合治疗可为供区管理提供额外益处。

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