| Objective:1.By comparing the shrinkage rate of free gingival graft(FGG)in orthodontic and non-orthodontic patients,the influence of orthodontic treatment on the contraction of grafted tissue flap was explored.To provide a preoperative reference basis for obtaining the expected amount of keratinized gingiva during orthodontic treatment with FGG,and to apply FGG more accurately.2.The observation of changes in gingival margin position provides a clinical evidence to determine whether FGG can reduce the risk of gingival recession during orthodontic treatment.Methods:Sixteen patients undergoing FGG were enrolled in this study.They were divided into orthodontic group and non-orthodontic group.Orthodontic group(group A): 7patients,7 tissue flaps and 15 teeth;Non-orthodontic group(group B): 9 patients,11 tissue flaps,16 teeth.1 month after FGG,orthodontic augmentation was started or continued in group A.The gingival recession,gingival margin location,horizontal and vertical length and surface area of the grafted tissue flaps were collected before,during and at 2 weeks,1 month,3 months and 12 months after surgery.The shrinkage rate of grafted tissue flap,changes in gingival recession and changes in gingival margin position were calculated.Results:1.The vertical contraction rate of transplanted tissue flap was 9.8±3.4%,14.4±3.7% and17.4±8.1% in group A at 1,3 and 12 months after operation,respectively;Group B was20.3±9.7%,22.4±11.0%,and 23.8±10.1%,respectively.The horizontal shrinkage rate of transplanted tissue flap was 5.2±2.3%,8.4±4.5% and 8.6±5.3% in group A at 1,3 and 12 months after operation,respectively;Group B was 14.4±8.4%,16.6±8.1% and18.7±7.0%,respectively.One month after FGG surgery,there was a statistically significant difference in the vertical contraction rate of the recipient tissue flap between the two groups(P < 0.05),and the contraction rate was higher in the non-orthodontic group.At 12 months after surgery,there were statistically significant differences in the horizontal direction and surface area shrinkage of the recipient tissue flap(P < 0.05),which were all higher than those in the non-orthodontic group.Compared with 3-12 months,there was no difference between the two groups in the contraction rate of transplanted tissue flap in all dimensions(P > 0.05).2.Twelve months after FGG operation,GR change was 1.58±0.58 mm in group A and1.52±0.79 mm in group B.The variation of gingival margin position was 1.77±0.66 mm in group A and 1.68±0.73 mm in group B.There was no significant difference in the amount of gingival recession and gingival margin position between the two groups(P >0.05).Conclusion:1.Significant contraction occurred in all dimensions of transplanted tissue flaps after FGG,and the contraction rate changed most significantly 0-1 month after the operation.Compared with non-orthodontic treatment,the horizontal length and surface area of the transplanted tissue flap shrank less.After 3 months,orthodontic treatment had no effect on the contraction rate of the vertical length of the transplanted tissue flap.2.The gingival margin shifted coronally after FGG.FGG,before or during orthodontic treatment,can prevent the occurrence and development of gingival recession. |
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