结缔组织墙技术联合植骨术在伴角化龈不足的骨下缺损中的效果评价

doi:10.19439/j.sjos.2026.04.004

上海口腔医学 ›› 2026, Vol. 35 ›› Issue (4): 370-375.doi: 10.19439/j.sjos.2026.04.004

结缔组织墙技术联合植骨术在伴角化龈不足的骨下缺损中的效果评价

陈汀兰¹, 温佳欢², 李梦迪¹, 宋忠臣^1,*, 倪靖^1,*

1.上海交通大学医学院附属第九人民医院牙周病科;
2.口腔综合科,上海交通大学口腔医学院, 国家口腔医学中心,口腔疾病国家临床研究中心,上海市口腔医学重点实验室, 上海市口腔医学研究所,上海 200011

收稿日期:2025-11-17 修回日期:2025-12-28 出版日期:2026-08-25 发布日期:2026-09-01
通讯作者: 倪靖,E-mail: natalie1229_9@126.com;宋忠臣,E-mail: szhongchen@sina.com。^*共同通信作者
作者简介:陈汀兰（1991—）,女,博士,住院医师,E-mail: chentinglan9h@163.com
基金资助:
国家自然科学基金（82301067）; 上海市卫生健康委员会临床专项青年项目（20244Y0189）; 上海交通大学医学院附属第九人民医院跨学科研究基金（JYJC202211）

Evaluation of the effect of the connective tissue graft wall technique combined with bone grafting in managing infrabony defects with keratinized tissue deficiency

Chen Tinglan¹, Wen Jiahuan², Li Mengdi¹, Song Zhongchen¹, Ni Jing¹

1. Department of Periodontology;
2. Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China

Received:2025-11-17 Revised:2025-12-28 Online:2026-08-25 Published:2026-09-01

摘要/Abstract

摘要： 目的: 探讨结缔组织墙技术（connective tissue graft wall technique, CTGWT）联合植骨术在治疗伴角化龈宽度（keratinized gingiva width,KGW）不足（< 2 mm）的骨下缺损中,对角化龈增宽及牙周骨再生的临床效果。方法: 选取2018年9月—2023年5月就诊于上海交通大学医学院附属第九人民医院牙周病科的7例存在骨下缺损且KGW不足2 mm的患者,均接受CTGWT联合植骨术治疗。比较治疗前后的骨下缺损深度（infrabony defect depth, IBD）、KGW、牙周探诊深度（probing pocket depth, PPD）、临床附着水平（clinical attachment loss, CAL）、牙龈退缩（gingival recession, REC）、牙间乳头高度（interdental papilla height, IP）、菌斑指数（plaque index, PLI）和出血指数（bleeding index, BI）。结果: 所有患者术后随访均超过12个月。影像学结果显示,IBD平均减少（3.97±1.96） mm,差异具有统计学意义（P<0.05）。临床指标方面,KGW平均增加（1.71±0.49） mm,PPD平均减少（3.21±0.76） mm,CAL平均减少（3.57±0.79） mm,上述差异均具有统计学意义（P<0.05）;而REC、IP、PLI及BI在术后随访期间未见显著变化。结论: 对于伴角化龈不足的骨下缺损,CTGWT联合植骨术可同时增宽角化龈及促进牙周骨再生。

关键词: 结缔组织墙技术, 骨下缺损, 角化龈不足, 牙周再生

Abstract: PURPOSE: To evaluate the clinical effect of the connective tissue graft wall technique (CTGWT) combined with bone grafting on keratinized gingiva widening and periodontal bone regeneration in the treatment of infrabony defects with insufficient(< 2 mm) keratinized gingiva width (KGW). METHODS: Seven patients with infrabony defects and KGW less than 2 mm, who were treated at the Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine between September 2018 and May 2023, were included. All patients underwent CTGWT combined with bone grafting. The infrabony defect depth (IBD), KGW, probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (REC), interdental papilla height (IP), plaque index (PLI), and bleeding index (BI) were compared before and after treatment. RESULTS: All patients were followed up for more than 12 months postoperatively. Radiographic findings showed a mean reduction in IBD of (3.97±1.96) mm, which was statistically significant (P<0.05). Regarding clinical parameters, KGW increased by (1.71±0.49) mm, PPD decreased by (3.21±0.76) mm, and CAL decreased by (3.57±0.79) mm; all these changes were statistically significant (P<0.05). In contrast, no significant changes were observed in REC, IP, PLI, or BI during the postoperative follow-up period. CONCLUSIONS: For infrabony defects accompanied by insufficient keratinized gingiva, CTGWT combined with bone grafting can significantly promote KGW as well as periodontal bone regeneration.

Key words: Connective tissue graft wall technique, Infrabony defect, Insufficient keratinized gingiva, Periodontal regeneration

中图分类号:

R782.1

陈汀兰, 温佳欢, 李梦迪, 宋忠臣, 倪靖. 结缔组织墙技术联合植骨术在伴角化龈不足的骨下缺损中的效果评价[J]. 上海口腔医学, 2026, 35(4): 370-375.

Chen Tinglan, Wen Jiahuan, Li Mengdi, Song Zhongchen, Ni Jing. Evaluation of the effect of the connective tissue graft wall technique combined with bone grafting in managing infrabony defects with keratinized tissue deficiency[J]. Shanghai Journal of Stomatology, 2026, 35(4): 370-375.

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结缔组织墙技术联合植骨术在伴角化龈不足的骨下缺损中的效果评价

Evaluation of the effect of the connective tissue graft wall technique combined with bone grafting in managing infrabony defects with keratinized tissue deficiency

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