The Application Of Subgingival Connective Tissue Flap In The Second-stage Surgery Of Upper Anterior Teeth Implantation

Objective:In the second-stage of implant surgery,the soft tissue around the implant was treated by the subgingival connective tissue flap and the conventional crest incision flap.The lip fullness score,Pink Esthetic Score（PES）and patient satisfaction were used to evaluate the application effect of the subgingival connective tissue flap in the second-stage surgery of maxillary anterior zone implantation.Methods:A total of 40 cases of patients with single missing anterior teeth were selected for implant restoration.All patients were evaluated as scarce of plumpness of labial soft tissue on implant site before the second-stage of implant surgery.Patients were divided into two groups according to the random number table method.In the observation group（20 cases）,the subgingival connective tissue flap was applied simultaneously to improve the labial soft tissue morphology of the implant in the second operation.Control group（20 cases）received conventional crest incision in the second-stage operation.The survival rate of the subgingival connective tissue flap in experimental group were observed.And we observed the success rate of implants in two groups during the following-up period,the convex profile on the facial aspect,pink esthetic score（PES）and patient satisfaction at following time points:before surgery;2 weeks,1 month and 6 month after the second-stage surgery.Statistical methods were used to organize and analyze data.Results:The clinical survival rates were 100%of the subgingival connective tissue flap in the experimental group.The success rate of implants in the two groups was100%during the follow-up period.The plumpness of labial soft tissue and pink esthetic score in the experimental group increased at each time point（T₀,T₁,T₂,T₃）after surgery,while the plumpness of labial soft tissue and pink esthetic score in the control group had no obvious change at each time point after surgery.The difference between the two groups was statistically significant（p<0.05）.The satisfaction scores of patients in the two groups were similar at T₀time point,and the aesthetic satisfaction scores of patients in the observation group were better than those in the control group at T₂and T₃time point,with statistical significance（p<0.05）.Conclusion:The subgingival connective tissue flap can be considered an effective method to improve plumpness of labial soft tissue and patient satisfaction,increase the pink esthetic score during second-stage surgery,which is suitable for the clinical application in implant restoration for soft tissue improvement.