目的·观察牙龈瘤切除术后分别使用原位复位瓣（normally positioned flap，NPF）和冠向复位瓣（coronally advanced flap，CAF）技术关闭创口对手术效果的影响。方法·纳入2022年8月—2023年12月就诊于上海交通大学医学院附属第九人民医院牙周病科的牙龈瘤患者共55例，分为NPF组和CAF组，在手术彻底切除牙龈瘤后，分别使用NPF和CAF技术缝合创口。记录基线时牙龈瘤的宽度（epulis width，EW）和高度（epulis height，EH），术后6个月时龈乳头的宽度（papilla width，PW）和高度（papilla height，PH），基线和术后6个月时的探诊深度（probing depth，PD）、附着丧失（attachment loss，AL）、角化牙龈宽度（keratinized gingiva width，KGW）等，并由2名牙周专科医师使用视觉模拟评分法（visual analogue scale，VAS）评估术后美学效果。使用t检验比较基线和术后6个月时的差异。结果·术后6个月时，CAF组的PD为（1.68±0.79）mm，与基线相比差异有统计学意义（P<0.001），但与NPF组差异没有统计学意义（P=0.365）；术后6个月时，CAF组的AL为（1.26±1.18）mm，与基线相比差异没有统计学意义（P=0.746），但是显著低于NPF组（P<0.001）；术后6个月时，CAF组的PH为（3.74±0.62）mm，显著高于NPF组（P<0.001），且前者的VAS得分显著优于后者（P<0.001）。结论·相对于传统的NPF技术，CAF技术可以有效改善牙龈瘤切除术后术区KGW，避免术后AL增加，减轻术后的牙周软组织缺损，改善术后美学效果。

Objective ·To evaluate the effects of normally positioned flap (NPF) and coronally advanced flap (CAF) techniques on clinical results after epulis excision. Methods ·A total of 55 patients with epulis who visited the Department of Periodontology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from August 2022 to December 2023 were included. The patients were divided into the NPF group and the CAF group. After epulis excision, the surgical area was closed using NPF or CAF technique. The following parameters were recorded: baseline epulis width (EW) and epulis height (EH); papilla width (PW) and papilla height (PH) at 6 months post-surgery; probing depth (PD), attachment loss (AL), and keratinized gingiva width (KGW) at both baseline and 6 months post-surgery. The esthetic outcomes were evaluated using a visual analog scale (VAS) by 2 periodontal specialists. t test was used to compare the differences in periodontal indices between baseline and 6 months post-surgery, as well as between the 2 flap techniques. Results ·At 6 months post-surgery, PD of the CAF group was (1.68±0.79) mm, significantly lower than at baseline (P<0.001), but not significantly different from that in the NPF group (P=0.365); the AL in the CAF group was (1.26±1.18) mm, not significantly different from baseline (P=0.746), but significantly lower than in the NPF group (P<0.001). At 6 months post-surgery, PH of the CAF group was (3.74±0.62) mm, significantly higher than that in the NPF group (P<0.001), and the VAS score of the CAF group was significantly higher than that of the NPF group (P<0.001). Conclusion ·Compared with NPF, CAF could effectively improve post-surgical KGW and reduce AL, which could prevent periodontal soft tissue defects, and improve esthetic outcome after epulis excision.