Dolińska Ewa, Duraj Ewa, Bernaczyk Marcin, Sulewska Magdalena, Pietruska Małgorzata
Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland.
Private Practice, ul. Żeromskiego1A/U1, 15-269 Bialystok, Poland.
J Funct Biomater. 2025 Sep 14;16(9):345. doi: 10.3390/jfb16090345.
Although ridge preservation procedures have been shown to prevent post-extraction bone loss, the effectiveness of using a flap or flapless surgical approach remains unclear. The aim of the study was to compare the mentioned above alveolar ridge preservation procedures in the esthetic region of maxilla. Twenty-nine patients were randomly assigned to receive flap ( = 14) or flapless ( = 15) alveolar ridge preservation procedure. Sockets were grafted with alloplastic biomaterial, then covered with a collagen membrane in both groups. Clinical examinations were performed over a 6-month observation period and radiological (CBCT) examination was conducted before and 6 months after treatment. For both after flap and flapless procedures, there was a reduction in interdental papillae height and keratinized tissue width, increase in buccal soft tissues thickness with a decrease in radiological buccal bone plate width, decrease in radiological buccal and lingual plate height (significantly for the flapless group) and radiological alveolar process width reduction (significantly in flapless group at the height of 5 mm and 7 mm from the bottom of the socket). A decrease in the radiological buccal bone plate width was observed, where the further measuring point was from the bottom of the alveolus. In the mucoperiosteal flap preparation, group buccal bone plate width reduction at the height 3 mm, 5 mm and 7 mm was significant and in the flapless group a significant decrease was observed from 5 to 9 mm from the bottom of the socket. Despite ridge preservation, there is soft tissue thickening and a decrease in bone height and width regardless of the flap/flapless method used.
尽管已证明牙槽嵴保存术可防止拔牙后骨吸收，但采用翻瓣或不翻瓣手术方法的有效性仍不明确。本研究的目的是比较上述在上颌美学区域的牙槽嵴保存术。29例患者被随机分配接受翻瓣（n = 14）或不翻瓣（n = 15）牙槽嵴保存术。两组的拔牙窝均植入异体生物材料，然后覆盖胶原膜。在6个月的观察期内进行临床检查，并在治疗前和治疗后6个月进行放射学（CBCT）检查。对于翻瓣和不翻瓣手术后，牙间乳头高度和角化组织宽度均减小，颊侧软组织厚度增加，放射学上颊侧骨板宽度减小，放射学上颊侧和舌侧骨板高度降低（不翻瓣组显著），放射学上牙槽突宽度减小（在距拔牙窝底部5 mm和7 mm高度处，不翻瓣组显著）。观察到放射学上颊侧骨板宽度减小，进一步测量点为距牙槽嵴底部。在黏骨膜瓣制备中，翻瓣组在3 mm、5 mm和7 mm高度处颊侧骨板宽度减小显著，不翻瓣组在距拔牙窝底部5至9 mm处观察到显著减小。尽管进行了牙槽嵴保存，但无论采用翻瓣/不翻瓣方法，均存在软组织增厚以及骨高度和宽度减小的情况。
