种植Ⅱ期“V”型和“+”型牙龈瓣的应用效果评价

中国口腔颌面外科杂志 ›› 2015, Vol. 13 ›› Issue (6): 525-529.

种植Ⅱ期“V”型和“+”型牙龈瓣的应用效果评价

林成，张晓雯，巴娇娇，李雅梅，艾娟，鲍飞

解放军第四七四医院口腔科，新疆乌鲁木齐 830013

收稿日期:2014-12-26 出版日期:2015-11-20 发布日期:2015-12-03
通讯作者: 林成，E-mail：implantlincheng@sina.com
作者简介:林成（1975-），男，博士，副主任医师

Clinical application and effect evaluation of “V” and “+” type gingival flaps at phase 2 implant surgery

LIN Cheng, ZHANG Xiao-wen, BA Jiao-jiao, LI Ya-mei, AI Juan, BAO Fei.

Department of Stomatology, No. 474 Military Hospital. Urumqi 830013, Xinjiang Autonomous Region, China

Received:2014-12-26 Online:2015-11-20 Published:2015-12-03

摘要/Abstract

摘要： 目的：探讨“V”型和“+”型牙龈瓣在种植Ⅱ期牙龈组织处理中的临床效果。方法：选取217例患者，完成331颗种植义齿。其中，美学区97颗，种植Ⅱ期手术采用“V”型牙龈瓣，术后2周~9个月完成最终义齿修复；磨牙区234颗，种植Ⅱ期手术采用“+”型牙龈瓣，术后2~5周完成最终义齿修复。美学区种植体术前，术后2周、3个月、6个月、1年行红色美学评分标准（PES）评估，采用 SPSS13.0软件包对数据进行样本均数q检验。磨牙区种植体术后随访6个月~1 a。结果：所有331颗种植体均完成种植修复。种植体无松动、脱落，功能良好。美学区牙龈“V”型瓣术后PES各指标持续改善。术后2周，PES分值为7.13±0.46，显著高于术前4.81±0.38（P<0.05）；术后3个月的分值（7.64±0.43）较术后2周显著提高（P<0.05）。术后6个月和1年PES分值趋于稳定（分别为8.18±0.47，8.22±0.45），较术后3个月差异显著（P<0.05）。磨牙区“+”型瓣术后2~3周，97.86%（229/234）的种植体获得良好的牙龈袖口形态。术后6个月~1 a，94.44% (221/234) 的种植义齿牙龈袖口健康，形态满意。结论：种植Ⅱ期手术采用“V”型和“+”型牙龈瓣，操作方便，创伤小，效果良好。

关键词: 种植Ⅱ期, 牙龈组织增量, 临床研究

Abstract: PURPOSE : The aim of this clinical study was to evaluate the gingival effects by using "V" and "+" type gingival flaps at phase 2 implant surgery. METHODS : Two hundred and seventeen patients were included and 331 implants were placed into the aesthetic zone (97) and the molar region(234). During phase 2 implant surgery, "V" and "+" type gingival flap was used in the aesthetic zone and the molar region, respectively. Pink esthetic scores (PES) analysis was made in the aesthetic zone at different time points after flap surgery. The data was analyzed with SPSS 13.0 software package. RESULTS : Three hundred and thirty-one implants showed good functions. The PES index showed a continuous improvement change in the lip side gingival of the aesthetic zone . In the molar region, 97.86 % implants acquired good gingival sleeves 2 weeks to 3 weeks after flap surgery and 94.44% implants maintained satisfactory gingival shapes 6 months to one year after flap surgery. CONCLUSIONS : "V" and “+” type of gingival flaps exhibited satisfactory clinical effects with the advantages of simple operations and less trauma.

Key words: Dental implant, Increment of gingival tissues, Clinical study

中图分类号:

R782.1

林成，张晓雯，巴娇娇，李雅梅，艾娟，鲍飞. 种植Ⅱ期“V”型和“+”型牙龈瓣的应用效果评价[J]. 中国口腔颌面外科杂志, 2015, 13(6): 525-529.

LIN Cheng, ZHANG Xiao-wen, BA Jiao-jiao, LI Ya-mei, AI Juan, BAO Fei.. Clinical application and effect evaluation of “V” and “+” type gingival flaps at phase 2 implant surgery[J]. China J Oral Maxillofac Surg, 2015, 13(6): 525-529.

参考文献

[1] Fürhauser R, Florescu D, Benesch T, et al. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score[J]. Clin Oral Implants Res, 2005, 16(6): 639-644.
[2] Schneider D, Grunder U, Ender A, et al. Volume gain and stability of peri-implant tissue following bone and soft tissue augmentation: 1-year results from a prospective cohort study [J]. Clin Oral Implants Res, 2011, 22(1): 28-37.
[3] Clementini M, Morlupi A, Canullo L, et al. Success rate of dental implants inserted in horizontal and vertical guided bone regenerated areas: a systematic review [J]. Int J Oral Maxillofac Surg, 2012, 41(7): 847-852.
[4] Man Y, Wang Y, Qu Y, et al. A palatal roll envelope technique for peri-implant mucosa reconstruction: a prospective case series study [J]. Int J Oral Maxillofac Surg, 2013, 42(5): 660-665.
[5] Khoury F, Happe A. Soft tissue management in oral implantology: a review of surgical techniques for shaping an esthetic and functional peri-implant soft tissues structure [J]. Quintessence Int, 2000, 31(7): 483-499.
[6] Barone R, Clauser C, Prato GP. Localized soft tissue ridge augmentation at phase 2 implant surgery: a case report [J]. Int J Periodontics Restorative Dent, 1999, 19(2): 141-145.
[7] Landsberg CJ. The eversed crestal flap: a surgical modification in endosseous implant procedures [J]. Quintessence Int, 1994, 25(4): 229-232.
[8] Landsberg CJ. Socket seal surgery combined with immediate implant placement: a novel approach for single-tooth replacement [J]. Int J Periodontics Restorative Dent, 1997, 17(2): 141-149.
[9] Nemcovsky CE, Moses O, Artzi Z, et al. Clinical coverage of dehiscence defects in immediate implant procedures: three surgical modalities to achieve primary soft tissue closure [J]. Int J Oral Maxillofac Implants, 2000, 15(6): 843-852.
[10] Jemt T. Regeneration of gingival papillae after single-implant treatment [J]. Int J Periodontics Restorative Dent, 1997, 17(4): 326-333.
[11] Choquet V, Hermans M, Adriaenssens P, et al. Clinical and radiographic evaluation of the papilla level adjacent to single-tooth dental implants. A retrospective study in the maxillary anterior region [J]. J Periodontol, 2001, 72(10): 1364-1371.
[12] Gomez-Roman G. Influence of flap design on peri-implant interproximal crestal bone loss around single-tooth implants [J]. Int J Oral Maxillofac Implants, 2001, 16(1): 61-67.
[13] Migliorati M, Amorfini L, Signori A, et al. Clinical and aesthetic outcome with post-extractive implants with or without soft tissue augmentation: a 2-year randomized clinical trial [J]. Clin Implant Dent Relat Res, 2015,17(5):983-995.