Department of Dental Implantology, The Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China.
Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China.
Medicine (Baltimore). 2024 Sep 27;103(39):e39806. doi: 10.1097/MD.0000000000039806.
Soft tissue management is critical in bone augmentation surgery to prevent wound dehiscence. Several strategies for passive tissue primary closure have been explored. This article introduces a flap design known as the modified "Poncho" technique (MPT), integrated with customized titanium mesh-mediated bone regeneration, and investigates the healing quality during the initial stages of an incision.
The cohort consisted of 5 patients undergoing customized bone regeneration procedures, concerned primarily with the successful integration and healing of the augmented bone site without complications such as wound dehiscence or infection.
All patients were diagnosed with insufficient bone volume requiring augmentation to support future dental implants, necessitating the use of customized titanium mesh for guided bone regeneration.
The MPT was detailed and applied during the customized bone regeneration procedures. Postoperative evaluations included recording complications and using Landry's healing index at intervals of 3, 7, 14, and 30 days post-surgery to assess the technique's performance in early wound closure.
The study found that 95.7% of surgery sites experienced uneventful soft tissue healing within the observation period. Only 1 of 23 sites exhibited partial wound dehiscence at postsurgical days 14 and 30, accompanied by mild inflammation. The Landry's healing index increased from 3 ± 0.47 to a final value of 4.69 ± 1.06, indicating substantial improvement in healing over time.
The MPT shows promise as an innovative approach for promoting passive and predictable primary wound closure beneath a digitally customized titanium mesh for bone regeneration, demonstrating a high rate of successful healing and minimal complications during the early postoperative phase.
软组织管理在骨增量手术中至关重要，可防止创口裂开。人们已经探索了几种被动组织一期缝合的策略。本文介绍了一种称为改良“篷布”技术（MPT）的皮瓣设计，该技术与定制钛网介导的骨再生相结合，并研究了切口初期的愈合质量。
该队列包括 5 名接受定制骨再生手术的患者，主要关注增强骨部位的成功整合和愈合，而无创口裂开或感染等并发症。
所有患者均被诊断为需要增强以支持未来牙种植体的骨量不足，需要使用定制钛网进行引导骨再生。
在定制骨再生过程中详细介绍并应用 MPT。术后评估包括记录并发症，并在术后 3、7、14 和 30 天使用 Landry 愈合指数进行评估，以评估该技术在早期伤口闭合中的表现。
研究发现，95.7%的手术部位在观察期内软组织愈合顺利。仅 23 个部位中的 1 个在术后第 14 和 30 天出现部分创口裂开，伴有轻度炎症。Landry 愈合指数从 3 ± 0.47 增加到最终的 4.69 ± 1.06，表明随着时间的推移愈合情况显著改善。
MPT 作为一种创新方法，有望在数字化定制钛网下促进被动且可预测的一期缝合，以促进骨再生，在术后早期阶段具有较高的愈合成功率和较少的并发症。
