目的 探讨牙龈瘤及其组织病理学分型的临床特征,并评估不同切除方式（手术刀、电刀或激光）对牙龈瘤预后的影响。方法 选取2021年8月—2024年7月就诊的217例牙龈瘤病例的临床数据作回顾性研究。获取的临床数据包括性别、年龄、牙龈瘤涉及的牙位及大小、就诊前是否存在牙周炎、牙龈瘤切除方式、是否拔除波及患牙、术中是否行根面平整等。根据术后牙龈瘤的复发情况评估疗效。结果 本研究中患者的平均年龄（40.25±11.32）岁,好发年龄区段在20~40岁;134例（61.75%）为女性患者,83例（38.25%）为男性患者,女性占比显著高于男性（χ2=11.986,P<0.001）。牙龈瘤位于前牙区130例（59.91%）,位于后牙区87例（40.09%）,前牙区占比显著高于后牙区（χ2=10.594,P=0.014）。组织病理学上,发病率由高到低依次是纤维性龈瘤（69.59%）、肉芽肿性龈瘤（21.20%）、外周型骨化纤维瘤（8.29%）和外周型巨细胞龈瘤（0.92%）。术后牙龈瘤复发方面,不同牙龈瘤切除方式、是否拔除患牙以及术前是否存在牙周炎症之间,复发率的差异均无统计学意义（P>0.05）,但术中实施根面平整者,其复发率显著低于未实施者（χ2=7.814,P=0.018）。结论 牙龈瘤多发于女性,常见于前牙区,组织病理学上以纤维性龈瘤为主;治疗方案中,使用不同的切除方式、拔除患牙并不会对牙龈瘤复发产生影响,但是术中对患牙进行根面平整可减少牙龈瘤的复发。
Objective To investigate the clinicopathological features of epulis and its histopathological subtypes and evaluate the outcomes of different excision methods （scalpel, electrotome, or laser） on the prognosis of epulis. Methods A total of 217 cases of epulis were retrospectively analyzed between August 2021 to July 2024. Gender, age, tumor location, size, symptoms of periodontitis at first visit, excision method, tooth extraction, and root planning during surgery were derived from medical records. Recurrence information was used to evaluate outcomes of different treatment regimens. Results The average age of the patients in this study was （40.25±11.32） years, with a common age range of 20‒40 years. Among them, 134 （61.75%） were female patients and 83 （38.25%）were male patients; epulis was significantly more common in females （χ2=11.986, P<0.001）. There were 130 cases （59.91%） of epulis located in the anterior tooth area and 87 cases （40.09%） in the posterior tooth area, and the proportion of anterior tooth area was significantly higher than that of posterior tooth area for epulis （χ2=10.594, P=0.014）. Histopathologically, the incidence rate from high to low was epulis fibromatosa （69.59%）, epulis granulomatosa （21.20%）, peripheral ossifying fibroma （8.29%）, and giant cell epulis （0.92%）. From the perspective of recurrence, the method of epulis resection, whether the affected tooth was removed, and whether there was periodontitis before surgery had no significant effects on recurrence （P>0.05）. However, the patients receiving root planing during surgery had a significantly lower incidence of recurrence than those who did not （χ2=7.814, P=0.018）. Conclusion Epulis is common in women and in the anterior tooth area, and fibrous hyperplasia is dominant in histopathological subtypes. When concerning treatment regimens, removal methods and tooth extraction would not interfere with recurrence. Root planing during surgery might help reduce the recurrence of epulis.
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