摘要：
Objective To evaluate and compare the clinical effects of three surgical procedures for the periodontal treatment of root surface exposure after resection of epulis.Methods Thirty patients with epulis were selected in this study and the exposed root surfaces of the patients' teeth were covered with laterally transposition flap,laterally pedicled transposition flap or coronally advanced flap combined with a connective tissue graft in the treatments of epulis.At the time of follow-up during the operation,3 months after operation and 6 months after operation,respectively,the color,shape and quality of the gum in the operation area and the coordination of the diaphragm and diaphragm were observed,and the root surface exposure (recession depth,RD) and angle were recorded.Keratinized tissue height (KTH),root coverage rate (RC) and patients' satisfaction with the surgery were also recorded.Results The flap widths in groups of laterally pedicled transposition flap and coronally advanced flap combined with a connective tissue graft were significantly wider than that in the group of laterally transposition flap at three-month and six-month follow-ups after the surgery.The width of keratoderma [(2.70 ± 1.16) mm] in the group of laterally transposition flap was significantly lower at 6 months postoperatively than that in the other two groups [(4.80±1.14) and (4.90± 1.66) mm,respectively] (P＜0.01).At the 6th month after surgery,the root flap coverage was at the lowest level [(24±43)％] in the group of laterally transposition flap,and it was significantly lower than that in the other two groups [(80±23)％ and (86±24)％,respectively] (P＜0.01).There was no significant difference of the root flap coverage between groups of laterally pedicled transposition flap and coronally advanced flap combined with a connective tissue graft.At the time of follow-up,patients were satisfied with the aesthetic effects of the three surgical procedures.Conclusions After the resection of the gingival tumor,the defect of the gingiva is caused.The laterally pedicled flap and pedicled flap combined with connective tissue transplantations for soft tissue repairing can achieve satisfactory aesthetic effects which are superior to the effect of simple flap technique.%目的 评价牙龈瘤切除后采用不同牙周术式进行患牙根面覆盖治疗的临床效果,为牙龈瘤切除后软组织缺损治疗方法的选择提供参考.方法 选择天津市口腔医院牙周科门诊2014年8月至2017年12月唇面牙龈瘤患者30例(女性21例,男性9例),在瘤体切除后分别采用翻瓣术(翻瓣术组,10例)、带蒂瓣术(带蒂瓣术组,10例)及带蒂瓣联合结缔组织移植术(联合术式组,10例)纠正术区的软组织缺损.在术中、术后3及6个月时随访,观察术区牙龈的色、形、质以及膜龈联合线的协调性,记录根面暴露情况及角化龈宽度,计算根面覆盖率,评价患者对手术的满意度.结果 3组患者术后3、6个月随访时角化龈宽度均较术中显著增宽,翻瓣术组术后6个月角化龈宽度[(2.70±1.16) mm]显著低于带蒂瓣术组及联合术式组[分别为(4.80±1.14)及(4.90±1.66) mm] (P＜0.01).术后6个月翻瓣术组根面覆盖率最低[(24±43)％],显著低于带蒂瓣术组[(80±23)％]及联合术式组[(86±24)％](P＜0.01).带蒂瓣术组与联合术式组术后6个月时根面覆盖率差异无统计学意义(P＞0.05).随访时患者对3种术式的美学效果评价均满意.结论 牙龈瘤切除后导致牙龈缺损,经带蒂瓣术及带蒂瓣联合结缔组织移植术进行软组织修复,均可取得满意的美学效果,且临床效果优于翻瓣术.
