| Objective:The contraction of the flap in the horizontal and vertical direction and the change of flap area within 6 months after free gingival graft were evaluated.To evaluate the scar of free gingival flap half a year after free gingival transplantationMethods:Free gingival graft was performed in 22 patients with insufficient or missing attached gingival width in the affiliated Stomatological Hospital of Kunming Medical University.And evaluation of periodontal indexes before operation.Intraoral photographs were taken immediately,two weeks,three months and six months after operation(camera aperture F29,sensitive ISO 160,shutter speed 1 to 125,shooting rate 1 to 2 times,manual focusing MF,lens long axis perpendicular to the operation area).The size and area of the transplanted valve in horizontal and vertical direction were measured by Photoshop,and the residual shrinkage ratio and shrinkage rate were calculated,and the flap was graded according to the standard of oral mucosa scar index half a year after operation.The relationship between the residual contraction ratio and time,the relationship between the residual contraction ratio and the biotype of the gum in the recipient area,and the difference of MSI score among different specialists and the relationship between MSI score and contraction rate were statistically analyzed by SPSS25.0 software,and there was significant difference between the two groups(P<0.05).Results:At two weeks,three months and six months after free gingival graft,the horizontal residual contraction ratios were 92.50±6.28,87.64±6.68,85.18±7.49,respectively,while the vertical residual contraction ratios were 85.00±10.08,75.89± 14.46 and 72.03± 14.47,respectively.At the same time point,there was significant difference in residual contraction ratio between horizontal and vertical(P<0.05).After operation,the contraction rate of the flap in horizontal,vertical and area increased with the increase of time.At two weeks,three months and six months after operation,the vertical shrinkage of the flap was higher than that of the horizontal flap,and nearly twice as high as that of the horizontal flap at two weeks,three months and six months after operation.The residual contraction ratio of the flap was 86.22± 13.43,92.50±6.28,85.00± 10.08 in the first three months after operation,respectively,in the area,horizontal direction and vertical direction of the flap,the residual contraction ratio of the flap was 86.22± 13.43,92.50±6.28 and 85.00± 10.08,respectively.The changes of residual contraction ratio in the last three months were 76.15± 14.47.87.64±6.68 and 75.89±14.46,respectively.The changes of residual contraction ratio of flap area,horizontal and vertical were significantly different between the two periods(P<0.05).There was no significant difference in the area,horizontal and vertical residual contraction ratio of the graft flap between the affected area and the gingival biotype.Two MSI index aesthetic assessments were performed by different specialists on the flap transplantation half a year after operation.In MSI index,the average score of suture marks was the lowest(0.80±0.70),while the average scores of scar width(1.27±0.76),scar color(1.22±0.64)and scar convexity(1.13±0.72)were higher.There was a positive correlation between the overall appearance of scar and the contraction rate of graft flap(rs=0.456,P<0.005),but there was no significant difference in scar width,scar crown,scar color,suture trace and the contraction rate of graft flap.Conclusions:After free gingival graft,the contraction rate of the transplanted flap in horizontal,vertical and area increased with the increase of time.After free gingival graft,the vertical contraction rate of the transplanted flap was higher than that of the horizontal contraction rate,and it was close to 2 times the level.The changes of the area,horizontal and vertical contraction rate of the transplanted valve were more obvious in the first 3 months after operation than in the latter 3 months The gingival biotype of the recipient area after free gingival graft had no significant effect on the contraction rate of the horizontal,vertical and area of the transplanted flap.MSI index has a good consistency in the evaluation of oral mucosa scar,among which periodontal doctors have higher requirements for oral soft tissue aesthetics Scar color and scar convexity have great influence on the aesthetic evaluation of free gingival flap after free gingival graft.There was a positive correlation between the overall appearance of scar and the contraction rate of transplanted flap. |
PDF Full Text Request