Genç ve yetişkin bireylerde serbest diş eti grefti iyileşmesinin kısa dönem klinik olarak değerlendirilmesi: pilot çalışma

Abstract

Amaç: Yaşın ilerlemesi, yara iyileşmesini etkileyerek fibroblast aktivitesini, kolajen sentezini azaltarak yara kontraksiyonu ve epitelizasyonu yavaşlatır. Bu pilot çalışmada, serbest dişeti greftinin (SDG) erken dönem iyileşmesinde yaşın etkilerini klinik olarak değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Çalışmaya sistemik olarak sağlıklı, genç (20-35 yaş) grupta 5 hasta ve yetişkin (50-65 yaş) grupta 5 hasta olmak üzere mandibular anterior bölgede keratinize diş eti dikey boyutu (KDDB) ≤2 mm olan toplam 10 hasta dahil edildi. Mandibular anterior bölgede alıcı yatak açıldı. Palatinal bölgeden alınan SDG alıcı bölgeye 6/0 ipek dikiş ile dikildi. Bütün ağız plak ve gingival indeks, sondalamada kanama, sondalama derinliği ve klinik ataşman seviyesi (KAS) operasyon öncesinde ve 3 ay sonra ölçüldü. Ameliyat bölgesi KDDB, greftin dikey ve yatay boyutu (GYB) operasyon sırasında ve sonrası 3. ayda kaydedildi. Greft alanı (GA), standart fotoğraflar üzerinde Java tabanlı bir program ile başlangıçta, 2. hafta ve 3. ayda ölçüldü. Büzülme yüzdesi (BY), GA' daki azalma üzerinden hesaplandı. Bulgular: Klinik ölçümler operasyon öncesi ve operasyon sonrası 3. ayda gruplar arası karşılaştırılması benzerdi (p>0,05), yalnızca KAS, 3. ayda yetişkin grupta daha yüksek olduğu saptandı (p<0,05). Her iki grupta da başlangıca göre 3. ayda KAS ve KDDB’de istatistiksel olarak anlamlı artış gözlendi (p<0,05). BY, tüm postoperatif ölçüm dönemlerinde genç gruba göre yetişkin grupta istatistiksel olarak anlamlı düşük bulundu (p<0,05). Yaş ve GYB ile BY arasında negatif korelasyon tespit edildi (p<0,05). Sonuç: Bu çalışma, SDG’nin erken dönem iyileşmesinde yaşın greft büzülmesini etkileyebileceğini göstermektedir.

Keywords

• Diş Eti
• Doku Grefti
• Yara İyileşmesi

Short-Term Clinical Evaluation of Free Gingival Graft Healing in Young and Adult Patients: A Pilot Study

Abstract

Objectives: Aging affects wound healing, reducing fibroblast activity, collagen synthesis, and slowing wound contraction and epithelialization. This pilot study aimed to assess the effects of age on early clinical healing outcomes following free gingival graft (FGG) operation. Materials and methods: The study included systemically healthy 10 patients; 5 patients in young group (aged: 20-35) and 5 patients in adult group (aged: 50-65) with ≤2 mm keratinized gingival width (KGW) at mandibular anterior region. A recipient bed was prepared. The FGG harvested from the palatal area was sutured to the recipient site with 6/0 silk sutures. Plaque and gingival index, probing depth, clinical attachment level (CAL), bleeding on probing and KGW were recorded before and 3 months after operation. Vertical and horizontal dimensions of graft (HDG) were recorded during surgery and 3 months after operation. Graft area (GA) was measured on standard photographs with a Java-based program at baseline, 2 weeks and 3 month follow-ups. The shrinkage percentage (SP) was calculated based on the reduction of GA. Results: Clinical measurements before and 3 months after operation were similar between groups (p>0.05) except CAL was higher in the adult group on 3 months (p<0.05). Statistically significant gain was found in CAL and KGW in both groups on 3 months (p<0.05). SP was significantly lower in the adult group than the young group at all post-surgical time points (p<0.05), and a negative correlation was found between age, HDG and SP (p<0.05). Conclusion: The present study suggests that age may affect the shrinkage of FGG at early healing stages.

Keywords

• Gingiva
• Tissue Graft
• Wound Healing

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