摘要：

目的：评估龈下结缔组织瓣在上前牙种植二期手术中的应用效果。方法：选择上前牙单颗缺失行种植修复，且种植二期手术术前评估为种植体唇侧软组织丰满度不足的患者，共40例。按随机数字表法将患者分成2组，观察组20例，二期手术时应用龈下结缔组织瓣改善种植体唇侧软组织形态；对照组20例，行常规嵴顶切开翻瓣完成二期手术。选取二期手术术前（T₀）、术后2周（T₁）、术后1个月（T₂）、术后6个月（T₃）为时间观测点，记录观察组结缔组织瓣的成活率，观察组和对照组种植体的存留率、唇侧丰满度、红色美学评分（pink esthetic score，PES）。运用统计学方法进行数据整理、分析。结果：观察组结缔组织瓣成活率为100%，2组种植体存留率在随访期内均为100%；唇侧软组织丰满度评分及红色美学评分结果显示，观察组术后各时间点唇侧软组织丰满度和红色美学评分较术前均有所增加，对照组术后各时间点唇侧软组织丰满度和红色美学评分较术前无明显变化，2组对比，差异有统计学意义（P<0.01）。结论：种植二期手术使用龈下结缔组织瓣能有效增加唇侧软组织丰满度，提高红色美学评分,适宜在临床美学种植修复改善软组织中应用。

关键词: 美学, 结缔组织移植, 牙种植

Abstract:

Objective: To evaluate the efficacy of subgingival connective tissue flap in the second-stage surgery of maxillary anterior zone implantation. Methods: A total of 40 cases of patients with single missing anterior teeth were selected for implant restoration. All patients were evaluated as scarce of plumpness of labial soft tissue on implant site before the second-stage of implant surgery. Patients were divided into two groups according to the random number table method. In the observation group(n=20 cases), subgingival connective tissue flap was applied simultaneously to improve the labial soft tissue morphology of the implant in the second operation. Control group(n=20 cases) received conventional crest incision in the second-stage operation. The survival rate of connective tissue flap in observation group was observed. We observed the success rates of implants in two groups during the following-up period and recorded the labial convex profile score and pink esthetic score （PES） at following time points: before surgery (T₀), 2 weeks (T₁), 1 month (T₂) and 6 months (T₃) after the second-stage surgery. Statistical methods were used to organize and analyze the data. Results: The clinical survival rate of the connective tissue flap was 100% in the observation group. The success rates of implants in the two groups were 100% during the follow-up period. The plumpness of labial soft tissue and pink esthetic score in the observation group increased at each time point after surgery, while the plumpness of labial soft tissue and pink esthetic score in the control group had no obvious change at each time point after surgery. The difference between the two groups was statistically significant(P<0.01). Conclusion: The subgingival connective tissue flap can be considered as an effective method to improve plumpness of labial soft tissue and increase the pink esthetic score during second-stage surgery, which is suitable for the clinical application in implant restoration for soft tissue improvement.

Key words: aesthetics, connective tissue graft, tooth implantation

中图分类号: 

• R782.4