腭侧旋转结缔组织瓣在上前牙种植修复中的临床研究

目的:探讨腭侧旋转结缔组织瓣在上颌前牙种植修复中的临床意义。方法:26例上颌前牙种植二期修复时,唇侧软组织有轻度缺损或凹陷,在牙槽嵴顶种植体位置作“H形”切口,形成颊侧带蒂粘骨膜瓣尖端带有腭侧的结缔组织瓣。将腭侧结缔组织旋转折叠,插入颊侧龈瓣内侧。愈合基台挤压龈乳头瓣诱导种植体周围龈乳头成形。2~4周后上部冠修复。6月后测量腭侧旋转结缔组织瓣移植前后唇侧牙龈丰满度等变化。结果:所有种植体均稳固,唇侧龈缘基本对称,手术前后唇侧软组织丰满度差为(1.10±0.45) mm,外形有明显改善,龈乳头顶到牙冠邻面接触点的距离为(2.05±0.76) mm。结论:腭侧旋转结缔组织瓣手术方法简单、易行,针对唇侧软组织缺损较少的部位可以较好地改善上颌前牙美学区种植义齿的软组织凹陷问题。

Clinical Study of Palatal Roll Connective Tissue Flap in the Esthetic Zone Implantation

Objective: To explore the application and the clinical outcome of palatal roll connective tissue flap technique in the esthetic zone implantation. Methods: Twenty-six patients,presenting a labial flat or concave profile in esthetic zone before second-stage surgery, underwent soft tissue augmentation using the palatal roll connective tissue flap technique. "H" incisions were operated on top of the alveolar ridges, with the two full-thickness papilla-sparing vertical incisions and a split-thickness horizontal incision. Labial mucoperiosteal pedicle flap tipped with a palatal connective tissue flap was formed. Then the palatal split-thichness flap was rolled on the buccal aspect. Papilla around the implant was shaped with healing abutment. Final crown was loaded after 2-4 weeks and the labial soft-tissue change was measured after 6 months. Results: All the implants were stable, and the improvement of labial soft tissue fullness was 1.10±0.45mm with symmetrical gingival margin and satisfied outline. The distance of papillae top to crown interproximal contact point was 2.05 ± 0.76mm. Conclusion: The palatal roll connective tissue flap has the potential to augment the labial soft-tissue before second-stage surgery in the esthetic zone implantation.