Matter J
J Clin Periodontol. 1982 Mar;9(2):103-14. doi: 10.1111/j.1600-051x.1982.tb01226.x.
Free gingival grafts can be utilized, alone or in combination with a coronally positioned flap, for the prevention and the treatment of gingival recession. The graft can be placed directly on the denuded root, as first described by Sullivan & Atkins (1968). This technique will provide adequate results, especially in cases with relatively little recession. After placing a free gingival graft in such an area, one can often observe bridging and/or creeping attachment. In the case of bridging, some of the grafted tissue will remain vital over the avascular zone, i.e. the root. Creeping attachment is the result of coronal migration of the grafted gingiva and will take place during the years following surgery. Bridging and creeping are most likely to occur in cases of narrow recession where the grafts had been placed directly over the denuded zone. In a second type of surgical procedure, an enlargement of the attached gingiva is first obtained through the graft. The area of recession is later covered by a coronally positioned flop. Several cases are presented which illustrate the results obtained with this procedure. In children, when there is insufficient attached gingiva, it is often desirable to place grafts before orthodonic therapy. In the prevention or treatment of gingival recessions, four possibilities may be considered: 1) no treatment, 2) placement of a graft to prevent recession, 3) stabilizing an existing recession, 4) attempt to cover the denuded root.
游离龈瓣移植术可单独使用，或与冠向复位瓣联合使用，用于预防和治疗牙龈退缩。如沙利文和阿特金斯（1968年）首次描述的那样，移植瓣可直接放置在裸露的牙根上。该技术能取得满意效果，尤其是在退缩相对较小的病例中。在这样的区域放置游离龈瓣后，常常可以观察到搭桥和/或爬行附着。在搭桥的情况下，一些移植组织会在无血管区（即牙根）上保持活力。爬行附着是移植牙龈向冠方迁移的结果，会在手术后数年发生。搭桥和爬行最有可能发生在狭窄退缩病例中，此时移植瓣直接放置在裸露区上方。在第二种手术方法中，首先通过移植瓣扩大附着龈。退缩区域随后用冠向复位瓣覆盖。本文展示了几个病例，说明了该手术方法取得的效果。在儿童中，当附着龈不足时，通常希望在正畸治疗前放置移植瓣。在预防或治疗牙龈退缩时，可以考虑四种可能性：1）不治疗，2）放置移植瓣以预防退缩，3）稳定现有的退缩，4）尝试覆盖裸露的牙根。
