16例牙龈瘤手术切除及愈合修复的临床体会

发布时间：2018-08-04 17:29

【摘要】：目的：本文以病例报告的形式，探讨牙龈瘤的病理分型、临床特点、手术方法及愈合修复的临床体会。方法：收集临床病例诊断为牙龈瘤的患者16例，其中15例为首发，1例为复发后首诊。所有患者经局部龈上、龈下洁刮治、根面平整术一周后，局麻下手术切除，手术按牙龈瘤的大小及生长位置分为单纯瘤体切除和瘤体切除结合结缔组织瓣修复，后者术中为覆盖创面所采用的结缔组织瓣包括：邻接组织单侧或双侧半厚瓣滑行移位修复、根向复位及游离龈瓣复位。组织切除后送检病理，按病理分型分成纤维性龈瘤、血管性龈瘤、巨细胞性龈瘤三组。术后一周，观察手术创面愈合情况，有无术后疼痛及肿胀等并发症，牙龈缘位置是否稳定，有无退缩，牙龈的颜色形态是否恢复正常及牙周组织愈合效果等。远期观察复发率。结果：16例患者中，纤维性龈瘤9例（56.2%），血管性龈瘤6例（37.5%），，外周巨细胞性龈瘤1例（6.25%）。术后对16例牙龈瘤患者进行6~18个月的随访，无1例复发。术区创面愈合良好，牙龈缘位置稳定，牙龈的色泽和外形恢复正常，无明显的疼痛、肿胀及瘢痕等并发症。结论：牙龈瘤有三种病理分型，每种病理分型有其各自的临床表现及组织学特点，病理分型与复发率之间无明显相关性。牙龈瘤的治疗原则是彻底切除瘤体、去除局部刺激因素及防止复发。手术方法因能对术区进行结缔组织瓣修复且术后创面愈合良好，膜龈位置稳定，并发症少，是治疗牙龈瘤的合理方法之一。
[Abstract]:Objective: to study the pathological classification, clinical features, surgical methods and healing and repair of gingival tumor in the form of case report. Methods: 16 cases of gingival tumor were collected, of which 15 cases were first diagnosed after recurrence. All the patients were treated by local supragingival, subgingival cleaning and curettage. One week after root surface leveling, local anesthesia was performed. The operation was divided into simple tumor resection and tumor resection combined with connective tissue flap according to the size and growth location of gingival tumor. The connective tissue flap used to cover the wound in the latter operation included: unilateral or bilateral half-thick flap sliding repair, root reduction and free gingival flap reduction. Histopathological examination was performed and divided into three groups: fibrous gingival tumor, vascular gingival tumor and giant cell gingival tumor. One week after operation, the healing of surgical wound was observed, whether there were complications such as pain and swelling after operation, whether the position of gingival margin was stable, whether there was withdrawal, whether the color shape of gingiva returned to normal, and whether the effect of periodontal tissue healing was observed. Long-term observation of recurrence rate. Results among the 16 cases, 9 cases (56.2%) were fibroplastic gingival tumor, 6 cases (37.5%) were vascular gingival tumor, 1 case (6.25%) was peripheral giant cell gingival tumor. 16 cases of gingival tumor were followed up for 6 ~ 18 months, none of them recurred. The wound healed well, the position of gingival margin was stable, the color and appearance of gingival returned to normal, and there was no obvious pain, swelling, scar and other complications. Conclusion: there are three types of gingival neoplasms, each of which has its own clinical and histological features, and there is no significant correlation between pathological classification and recurrence rate. The treatment principle of gingival tumor is to remove local irritation factors and prevent recurrence. The operative method is one of the reasonable methods for the treatment of gingival tumor because it can be repaired by connective tissue flap and the wound healing is good the position of membranous gingiva is stable and the complications are few.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.8

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