目的：本系统综述讨论了牙髓手术中可能对口腔健康相关生活质量（OHRQoL）产生影响的皮瓣设计。
方法：搜索了四个电子数据库(PubMed，科克伦图书馆,WebofScience,和Scopus），以确定截至2019年11月的所有研究，这些研究调查了皮瓣设计对健康成年人牙龈衰退和生活质量的影响。
结果：初始搜索确定了2701个参考。本系统评价包括10项研究；2项为随机临床试验，8项为非随机临床试验。研究表明，牙龈切口增加了牙龈退缩的风险，并降低了OHRQoL。荟萃分析中包括两项与牙龈衰退有关的研究。汇总结果表明，与牙龈切口相比，边缘下切口的牙龈退缩加权平均差降低了0.31mm（95％CI：0.12-0.51）（p=0.002）。
结论：硫酸切口皮瓣对牙龈水平和OHRQoL有不利影响。所有非随机研究都有统计学上显著的偏倚，所有研究的样本量都相对较小。牙龈凹陷和OHRQoL较低与牙龈切口有关。需要进一步调查以提供更多证据。
OBJECTIVE: This systematic
review addressed flap designs in endodontic surgery which can have an impact on the Oral Health Related Quality of Life (OHRQoL).
METHODS: Four electronic databases were searched (PubMed, Cochrane Library, Web of Science, and Scopus) to identify all studies up to November 2019 that investigated the effect of flap designs on gingival recession and quality of life among healthy adults.
RESULTS: The initial search identified 2701 references. Ten studies were included in this systematic
review; two were randomised clinical trials and eight were non-randomised clinical trials. Studies showed that sulcular incision increases the risk of gingival recession and decreases OHRQoL. Two studies were included in the meta-analysis in relation to gingival recession. The pooled results demonstrated that submarginal incision showed a decreased weighted mean difference in gingival recession by 0.31 mm (95% CI: 0.12 - 0.51) (p = 0.002) compared to sulcular incision.
CONCLUSIONS: Sulcular incision flap unfavourably affect the level of gingiva and OHRQoL. All nonrandomised studies had a statistically significant bias and the sample sizes in all studies were relatively small. More gingival recession and lower OHRQoL were associated with sulcular incision. Additional investigations are warranted to provide more evidence.
