腭部作为口腔软组织供区的实践要点

doi:10.3969/j.issn.1005-4979.2020.05.001

摘要/Abstract

摘要：

口腔结缔组织供区主要包括硬腭、上颌结节及下颌磨牙后垫区，其中硬腭是最常用的软组织供区。由于硬腭的大小、形态、黏膜厚度，以及神经血管的位置会影响其获取技术的选择及可获得移植物的大小。因此，术者应熟悉腭部供区的解剖结构及获取技术的手术技巧，才能避免软组织手术时并发症的发生。本文就近年的相关文献结合笔者的临床经验，对硬腭的解剖结构及其作为结缔组织移植物供区的获取技术进行总结，为临床医生提供参考。

关键词: 软组织移植, 结缔组织, 硬腭黏膜

Abstract:

Oral connective tissue donor sites include hard palate, maxillary tuberosity, and mandibular retromolar region. Connective tissue grafts are mainly harvested from the lateral palatal. Size, shape, mucosal thickness and the location of neurovascular bundles of the hard palate can affect the choice of surgical technique and dimensions of the donor tissue harvested. Oral surgeons should be familiar with the anatomy of the palatal donor site to perform soft tissue surgeries and handle complications. Based on the relevant literatures in recent years and combined with the author’s clinical experiences, this paper summarizes palatal anatomy as the soft tissue donor site and various soft tissue surgery techniques that are available in order to provide references for the clinicians.

Key words: soft tissue graft, connective tissue, hard palatal mucosa

中图分类号:

R782

满毅, Vicha Huangphattarakul. 腭部作为口腔软组织供区的实践要点[J]. 《口腔颌面外科杂志》, 2020, 30(5): 265-271.

MAN Yi, Vicha Huangphattarakul. Practical Points of Palate as Oral Soft Tissue Donor Site[J]. 《Journal of Oral and Maxillofacial Surgery》, 2020, 30(5): 265-271.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2020/V30/I5/265

图/表 10

图1 腭部黏膜组织学结构示意图

Figure 1 Schematic of histology of hard palatal mucosa

图2 安全区域示意图^[29]

Figure 2 Safety zone schematic^[29]

图3 Single incision 技术

Figure 3 Single incision technique

图4 Single incision 技术获取带有骨膜的上皮下结缔组织

Figure 4 Subepithelial connective tissue graft with periosteum obtained through single incision technique

图5 通过游离龈技术获取的移植物

Figure 5 Graft obtained through free gingival graft technique

图6 于口外应用刀片去上皮化获得的结缔组织移植物

Figure 6 Free gingival graft de-epithelialized extra-orally to obtain connective tissue graft

图7 患者静脉血离心获得的凝胶状CGF

Figure 7 Patients’ venous blood was centrifuged to obtain gelatinous CGF

图8 CGF压制成膜，可覆盖于游离龈移植供区或填入上皮下结缔组织供区表层瓣下方

Figure 8 CGF compressed to form a membrane, is used to cover the free gingival graft donor site or placed under the primary flap in subepithelial connective tissue graft donor site

图9 CGF膜覆盖去上皮游离龈移植供区，三角褥式缝合压迫固定

Figure 9 CGF membrane placed at the free gingival graft donor site and compressed with triangular mattress suture

图10 止血压板

Figure 10 Surgical stent

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