即刻种植联合组织清理术对犬种植体周围软组织形态的影响

目的:探讨即刻种植联合组织清理术对种植体周围软组织形态的影响。方法:选择21只成年杂种犬,建立动物模型,行即刻种植。根据不同手术方式,将其分为唇侧黏骨膜瓣滑行组、自体游离龈瓣移植组、异种脱细胞真皮基质移植组,3个月后进行烤瓷冠修复。修复后1个月处死动物,切取标本,观察3组种植体周围软组织的形态变化。采用SPSS20.0软件包对数据进行t检验。结果:3组种植体周围软组织愈合情况均呈现良好水平,其中,唇侧黏骨膜滑行组修复效果较其余2组差,主要与生理解剖结构被破坏有关。自体游离龈瓣移植组及异种脱细胞真皮基质移植组一次手术关闭创面,减少愈合负担,并对周围软组织形态不良影响较少。3组种植体龈沟探诊深度在修复前、后无显著差异;修复1个月后,3组牙龈指数均显著高于修复术前（P<0.05）,其中唇侧黏骨膜瓣滑行组附着龈宽度比修复术前显著减少（P<0.05）。结论:即刻种植联合周围组织清理技术对于周围软组织修复具有积极作用,能够取得明显的种植美学修复效果。

Effect of immediate implantation combined with tissue cleaning on the morphology of soft tissue around the implant in dogs

PURPOSE:To study the effect of immediate implantation combined with tissue cleaning on the morphology of soft tissue around the implant in dogs. METHODS: Totally 21 adult healthy hybrid dogs were selected for the experiment, which were divided into 3 groups based on different modes of operation: slipping mucoperiosteum flaps, free gingival flaps and allogeneic dermal matrix. Porcelain crown restoration was applied 3 months later. After 1-month of observation, all dogs were sacrificed in order to evaluate the morphological changes of the soft tissue around the implants. SPSS20.0 software package was used to analyze the data obtained. RESULTS: The healing of soft tissue around the implants in 3 groups were all good. Compared with the other two groups, the repairing outcome of the slipping mucoperiosteum flaps was worse. Free gingival flaps and allogeneic dermal matrix had the advantages on less negative effect of recovery and the morphology of soft tissue around the implant. The depth of sulcus in 3 groups had no significant difference. Nevertheless, the gingival index in the slipping mucoperiosteum flaps increased significantly after operation（P<0.05）. CONCLUSIONS: Immediate implantation combined with tissue cleaning has a positive effect on the morphology of soft tissue around the implant.