[Evaluation of the results of vestibuloplasty according to microhemodynamics and oxygenation in the mucous membrane of the alveolar ridge].

Abstract

Objective: Evaluation of the effectiveness of vestibuloplasty according to microhemodynamics and oxygenation in the mucous membrane of the alveolar ridge.

Materials and methods: To achieve this goal, a clinical and functional study was carried out in the mucous membrane of the alveolar ridge after vestibuloplasty in 80 patients (35 men and 45 women) aged from 18 to 65 years, average age 41.5±1.9 years, without somatic pathology with a diagnosis according to ICD-10 «K08.1» with an insufficient or completely absent zone of attached keratinized gums, 2 groups were separated from them depending on the type of treatment: mail group comprised 40 people and was divided into 2 subgroups. In subgroup A a free gingival graft (FGG) was used as a covering material (subgroup A) with removable device. In subgroup B (20 people), a collagen matrix and a removable device were used. Control group consisted of subgroup 1 (20 people), in which FGG was used as a covering material, and subgroup 2 (20 people), in which collagen matrix was used. Using laser Doppler flowmetry (LDF), we determined the microcirculation index which characterizes the level of tissue blood flow. Oxygenation studies were carried out using optical tissue oximetry (OTO), determining the perfusion oxygen saturation index and the specific oxygen consumption index. Statistical processing of the results was carried out using MS Excel and MS Access.

Results: Analysis of the results of LDF in the main group (subgroup A and B) showed that 3 days after surgery, the level of blood flow (M) and its intensity (σ) decreased by 35% and 54%, and 24% and 49%, respectively, indicating the development of ischemia in the microvasculature which resolved after 14 days in subgroup A and 1 month in subgroup B. In the control group (subgroup 1 and 2), the dynamics of tissue blood flow 3 days after surgery were similar, but microcirculation indicators were restored after 1 and 3 months, respectively. According to optical OTO in the main group 3 days after surgery, oxygenation rates decreased by 36% and 50% (subgroup A) and 20% and 41% (subgroup B) indicating the development of hypoxia in the tissues which resolved after 14 days and 1 month after surgery, respectively. In the control group (subgroup 1 and 2), oxygenation indicators were restored after 1 and 3 months, respectively.

Conclusions: After vestibuloplasty using FGG or collagen matrix and a removable denture, microhemodynamics and oxygenation in the mucous membrane of the alveolar ridge restored earlier than in controls.