游离龈移植术后龈瓣收缩效果的临床研究

目的:评估游离龈移植术后3月内龈瓣在垂直向、水平向宽度改变并计算其表面积的收缩情况。方法:选取23例Miller Ⅲ类牙龈退缩患者,因下颌前牙区颊侧角化龈宽度不足(2 mm)行游离龈移植术。分别比较基线、术后1和3月游离龈瓣水平向及垂直向宽度的改变并计算龈瓣表面积的收缩情况。结果:经游离龈移植术的23例患者术区游离龈全部成活,牙龈无红肿,附着龈宽度可达3-5 mm。基线处、术后1月、3月水平向龈瓣宽度分别为9.83±1.7、8.97±1.5、8.48±1.65 mm;基线水平、术后1月、3月垂直向龈瓣宽度分别为4.02±0.61、3.61±0.67、3.24±0.67 mm。与基线时比较,术后1月、3月水平向、垂直向龈瓣宽度、龈瓣表面积均明显降低,差异均具有显著差异(P0.05)。结论:游离龈移植术可增加牙龈退缩患者的附着龈宽度,术后龈瓣存在水平向和垂直向收缩,且垂直向更明显。此外,龈瓣收缩存在个体差异。

Clinical Efficacy of Free Gingival Graft Shrinkage in the Treatment of Gingival Recession

ABSTRACT Objective: To evaluate the shrinkage of free gingival graft in horizontal and vertical dimensions and calculate the changes in the surface area of gingival graft in the treatment of gingival recession within 3 months. Methods: A total of 23 patients with Miller class III gingival recession and insufficient keratinized gingivae (<2 mm) in their mandibular anterior teeth were enrolled and un- derwent free gingival graft. The vertical shrinkage, horizontal shrinkage and change in the surface area were assessed at baseline, 1 and 3 months postoperation. Results: The free gingivae of 23 patients survived after free gingival graft operation and gingivae had no swelling and the attached gingiva width was up to 3-5 mm. The vertical dimension of gingiva was 9.83±1.7, 8.97±1.5, 8.48±1.65 mm at base- line, 1 month and 3 months respectively. The horizontal dimension of gingiva was 4.02±0.61, 3.61±0.67, 3.24±0.67 mm at baseline, 1 month and 3 months respectively. Compared with the baseline, the vertical shrinkage, horizontal shrinkage and the surface area were decreased at 1 and 3 months postoperation(P<0.05). Conclusion: Free gingival graft was an effective method for enhancing the width of keratinized gingivae. The shrinkage of horizontal and vertical dimensions of the grafts almost existed every patients with time, especially in the latter dimensions. In addition, the different dimensional changes was observed in individual level.