Sharma Shipra, Mehra Hemant, Gupta Hemant, Agarwal Rashmi, Gangwar Ankit, Kumar Abhigyan
Department of Oral and Maxillofacial Surgery, Babu Banarsi Das College of Dental Sciences, BBD City, Faizabad Road, Lucknow, 226028 India.
J Maxillofac Oral Surg. 2023 Sep;22(3):525-532. doi: 10.1007/s12663-022-01709-2. Epub 2022 Apr 19.
Oral and maxillofacial surgery deals with wide range of oral defects, wound closure, tissue resection, and tissue reconstruction. The purpose of our study is to use amniotic membrane for closure of post surgery defect in patient of oral submucous fibrosis to utilize its growth factor and scaffold nature for effective healing and to evaluate effectiveness of amniotic membrane in treatment outcome. The objectives are to compare post-operative mouth opening, healing of amniotic membrane and buccal fat pad.
Diagnosed patients with OSMF are divided into two surgical site Group I ( = 5patients)-Left side buccal mucosa in which resection of fibrous band with coronoidectomy followed by reconstruction of the mucosal defect with BFP. Group II-Right side buccal mucosa in which resection of fibrous band with coronoidectomy followed by reconstruction of the mucosal defect with freeze dried irradiated amniotic membrane.
This study suggested that in comparison to buccal fat pad flap, the HAM graft is a better option for oral reconstruction in terms of infection, graft failure, MMO, inflammation, pain. Outcome indicated that the HAM is biologically ideal graft for oral wounds and could be used as clinical alternative for various repair surgery for oral defects.
The amniotic membrane was found easy to handle and easy to use with inherent hemostatic property which is observed in all patients. No patients had shown any evidence of any complications. Good pain control observed in patients throughout postoperative period.
口腔颌面外科涉及广泛的口腔缺损、伤口闭合、组织切除和组织重建。我们研究的目的是使用羊膜来闭合口腔黏膜下纤维化患者的术后缺损,利用其生长因子和支架特性实现有效愈合,并评估羊膜在治疗效果中的有效性。目标是比较术后张口度、羊膜和颊脂垫的愈合情况。
确诊为口腔黏膜下纤维化的患者被分为两个手术部位组。第一组(n = 5例患者)为左侧颊黏膜,切除纤维带并行冠突切除术,随后用颊脂垫重建黏膜缺损。第二组为右侧颊黏膜,切除纤维带并行冠突切除术,随后用冻干辐照羊膜重建黏膜缺损。
本研究表明,与颊脂垫瓣相比,就感染、移植物失败、最大张口度、炎症、疼痛而言,人羊膜移植是口腔重建的更好选择。结果表明,人羊膜是口腔伤口的理想生物移植物,可作为口腔缺损各种修复手术的临床替代方法。
发现羊膜易于操作和使用,所有患者均具有内在止血特性。没有患者出现任何并发症的迹象。在整个术后期间观察到患者的疼痛得到良好控制。