用丝缝合线和氰基丙烯酸丁酯修复牙周皮瓣的临床-组织学比较评价

H. Aeran, A. Tuli, Ila Sharma
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摘要

牙周炎是一种炎症性疾病,由细菌之间的相互作用导致炎症和结缔组织附着体的破坏。皮瓣手术是深牙周袋最常用的治疗方式。几十年来,许多缝合材料,如丝绸和尼龙被用于近似皮瓣。在目前牙周进展的情况下,纤维蛋白胶是一种很好的替代皮瓣近似,具有更好的临床和组织学结果。本随机临床组织学研究的目的是比较改良皮瓣手术时,接近丝缝合和氰基丙烯酸酯正丁酯生物胶愈合。在这项临床组织学研究中招募了30名患者。A组采用3-0条黑色编织丝缝合线(@TRUSILK)缝合手术部位,B组采用滴剂滴入的氰基丙烯酸酯正丁酯生物胶粘剂(@EPICLOS)缝合皮瓣。患者在手术1周后被召回以去除缝合线和任何氰基丙烯酸酯。在基线和第7天采集所有参数(临床和组织学)。组内组间比较,龈指数(GI)、乳头边缘附着指数(PMA)、Turesky-Gilmore-Glickman修饰的Quigley Hein斑块指数(TQHPI)、创面愈合指数(WHI)及组织学参数(炎症细胞和血管密度)均在第7天显著降低。正丁基氰基丙烯酸酯(B组)在降低临床和组织学参数方面比丝线(A组)更有效。
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A clinico-histological comparative evaluation of healing of periodontal flaps when approximated with silk sutures and n-butyl cyanoacrylate
Periodontitis is an inflammatory disease which results by the interaction between bacteria leading to inflammation and destruction of the connective tissue attachment apparatus. Flap surgeries are most frequently employed treatment modality for deep periodontal pockets. Over the decades, many suture materials like silk and nylonare being used for the approximation of the flaps. In the present scenario of periodontal advancements, fibrin glue manifests to be a great alternative to flap approximation with better clinical and histological results.This randomized clinico-histological study aims to compare the healing of modified flap operation when approximated with Silk suture and N-butyl cyanoacrylate bioadhesive.Thirty patients were recruited in this clinico-histological study. In Group A, surgical site was approximated by 3-0 black braided silk sutures (@TRUSILK) and in Group B, N-butyl cyanoacrylate bioadhesive (@EPICLOS) was used by driplets for flap approximation. Patients were recalled for removal of sutures and any cyanoacrylate present after 1 week of surgery. All the parameters (clinical and histological) were taken at baseline and at 7 day.On intra and inter group comparison all the clinical parameters i.e., Gingival index (GI), Papillary Marginal Attachment (PMA) Index, Turesky-Gilmore-Glickman modification of Quigley Hein Plaque Index (TQHPI), Wound healing index (WHI) and histological parameters i.e., inflammatory cells and vascularity shows significant reduction at 7 day in group B (N-butyl-cyanoacrylate).N-butyl-cyanoacrylate (Group B) is more effective in reducing the clinical and histological parameters than Silk sutures (Group A).
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