上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2020, Vol. 40 ›› Issue (1): 139-.doi: 10.3969/j.issn.1674-8115.2020.01.023

• 短篇论著 • 上一篇    

改良侧向转位瓣结合隧道术治疗上颌单牙位软组织缺损的临床效果

范雅丹，龚 寅，董家辰，束 蓉   

  1. 上海交通大学医学院附属第九人民医院牙周病科，上海市口腔医学重点实验室，上海市口腔医学研究所，国家口腔疾病临床研究中心，上海 200011
  • 出版日期:2020-01-28 发布日期:2020-03-05
  • 通讯作者: 束 蓉，电子信箱：shurong1977@163.com。
  • 作者简介:范雅丹（1993—），女，住院医师，硕士；电子信箱：535823374@qq.com。
  • 基金资助:
    国家自然科学基金（81570977）；上海市教育委员会高原高峰学科建设计划（2015523）。

Clinical outcomes of modified lateral advanced flap combined with tunnel technique for the treatment of maxillary isolated soft tissue defect

FAN Yan-dan, GONG Yin, DONG Jia-chen, SHU Rong   

  1. Department of Periodontology, Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology; National Clinical Research Center for Oral Diseases, Shanghai 200011, China
  • Online:2020-01-28 Published:2020-03-05
  • Supported by:
    National Natural Science Foundation of China (81570977); Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Support (2015523).

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摘要： 目的·观察改良侧向转位瓣技术（lateral advanced flap，LAF）联合隧道技术（tunnel technique，TUN）治疗上颌单牙位软组织缺损的临床效果。方法·选取上颌单牙位软组织缺损病例，使用改良LAF结合TUN，并联合上皮下结缔组织移植术（subepthelial connective tissue graft，SCTG）进行缺损区软组织增量。术后随访1年。比较手术前后的探诊深度（probing depth，PD）、附着丧失（clinical attachment loss，CAL）、退缩高度（recession height ，RH）、退缩宽度（recession weight，RW）、牙龈厚度（gingiva thickness，GT）、角化龈宽度（keratinized tissue width，KTW），并计算平均根面覆盖率(root coverage rate，RC%)。结果·共纳入3例上颌软组织缺损患者，其中Miller Ⅱ类1例、Ⅲ类2例，术后1年平均RC%为(78.89±18.36)%。平均CAL由（6.00±1.00）mm变为（1.83±1.61）mm，RH由（5.33±0.58）mm变为（1.17±1.04）mm，RW由（6.00±1.32）mm变为（4.50±3.91）mm，GT由（0.83±0.29）mm变为（1.83±0.76）mm，KTW由（0.83±0.76）mm变为（5.50±0.50）mm。结论·改良LAF联合TUN可治疗不同病因导致的前牙区单牙位软组织缺损。

关键词: 牙龈退缩, 侧向转位瓣, 隧道技术, 上颌单牙位软组织缺损, 根面覆盖率

Abstract:

Objective · To observe the clinical outcome of the modified laterally advanced flap combined with tunnel technique for the treatment of maxillary isolated soft tissue defects. Methods · Three of maxillary isolated soft tissue defects were selected, and the modified lateral advanced flap combined with tunnel technique and subepithelial connective tissue graft was performed to repair the soft tissue defects. Pocket depth (PD), clinical attachment loss (CAL), recession height (RD), recession weight (RW), gingiva thickness (GT), and keratinized tissue width (KTW) were measured at baseline and one-year follow-up after treatment and the root coverage rate (RC%) was calculated. Results · Totally three patients were treated, two Miller Ⅲ and one Miller Ⅱ. The mean RC% at one-year follow-up was (78.89±18.36)%. The mean CALs at baseline and follow-up were (6.00±1.00) mm and (1.83±1.61) mm. The mean RHs at baseline and follow-up were (5.33±0.58) mm and (1.17±1.04) mm. The mean RWs at baseline and follow-up were (6.00±1.32) mm and (4.50±3.91) mm. The mean GTs at baseline and follow-up were (0.83±0.29) mm and (1.83±0.76) mm. The mean KTWs at baseline and follow-up were (0.83±0.76) mm and (5.50±0.50) mm. Conclusion · In the treatment of maxillary isolated soft tissue defect, the modified lateral advanced flap combined with tunnel technique has broad application and valid clinical outcome.

Key words: gingival recession, laterally advanced flap, tunnel technique, maxillary isolated soft tissue defect, root coverage rate