即刻种植同期行软组织增量手术的临床效果与考量

doi:10.12337/zgkqzzxzz.2025.12.008

中国口腔种植学杂志 ›› 2025, Vol. 30 ›› Issue (6): 557-565.DOI: 10.12337/zgkqzzxzz.2025.12.008

• 软组织增量与牙种植专题 • 上一篇下一篇

即刻种植同期行软组织增量手术的临床效果与考量

王斌¹, 姜懿轩¹, 满毅²

¹郑州大学第一附属医院口腔科 450001,河南;
²四川大学华西口腔医院口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心 610041

收稿日期:2025-09-05 出版日期:2025-12-30 发布日期:2025-12-23
通讯作者: 满毅,Email：manyi780203@126.com,电话：028-85503579
作者简介:王斌,博士、主治医师,研究方向：口腔种植学。
满毅,教授、主任医师、博士研究生导师,研究方向：口腔软硬组织再生。
基金资助:
四川省卫生健康委员会科技项目（24CXTD13）; 四川省杰出青年科学基金项目（2025NSFJQ0067）; 河南省自然科学基金青年项目（252300421600）

Clinical outcomes and considerations of concurrent soft tissue augmentation with immediate implant placement

Wang Bin¹, Jiang Yixuan¹, Man Yi²

¹Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, Henan, China;
²West China Hospital of Stomatology & State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Chengdu 610041, Sichuan, China

Received:2025-09-05 Online:2025-12-30 Published:2025-12-23
Contact: Man Yi, Email: manyi780203@126.com, Tel: 0086-28-85503579
Supported by:
Science and Technology Project of Sichuan Provincial Health Commission (24CXTD13); Sichuan Science and Technology Program (2025NSFJQ0067); Henan Provincial Natural Science Foundation Youth Program (252300421600)

摘要/Abstract

摘要： 美学区患牙的即刻种植具有疗程短、手术次数少等优势,已被证实为一种可靠的治疗方法。然而,种植手术的外科创伤会引起牙槽骨与软组织的改建,此类软硬组织轮廓的变化可能带来美学风险。近年来,在即刻种植同期进行软组织移植被认为是降低该风险的有效策略,并成为研究热点。本文基于近期发表的循证医学证据,针对即刻种植同期行软组织移植的治疗效果、材料选择及即刻修复等方面的关键问题进行阐述,以期为临床医师的治疗决策提供参考。

关键词: 即刻种植, 软组织移植, 结缔组织移植, 软组织替代材料, 龈缘退缩

Abstract: Immediate implant placement is a reliable treatment modality for replacing compromised teeth in the esthetic zone, offering advantages such as reduced treatment time and fewer surgical interventions. However, the surgical trauma associated with immediate implant placement induces remodeling of the alveolar bone and surrounding soft tissues, and subsequent changes in hard and soft tissue contours may pose esthetic risks. Concurrent soft tissue grafting performed at the time of immediate implant placement has emerged as a promising strategy to mitigate these risks and has recently become a focus of research. This review synthesizes recent evidence-based findings to discuss key considerations regarding clinical outcomes, material selection, and immediate restoration in the context of concurrent soft tissue grafting with immediate implant placement, thereby providing clinical decision-making support for practitioners.

Key words: Immediate implant placement, Soft tissue grafting, Connective tissue grafting, Soft tissue substitutes, Gingival recession

王斌,姜懿轩,满毅. 即刻种植同期行软组织增量手术的临床效果与考量[J]. 中国口腔种植学杂志, 2025, 30(6): 557-565. DOI: 10.12337/zgkqzzxzz.2025.12.008

Wang Bin, Jiang Yixuan, Man Yi. Clinical outcomes and considerations of concurrent soft tissue augmentation with immediate implant placement[J].Chinese Journal of Oral Implantology, 2025, 30(6): 557-565.DOI: 10.12337/zgkqzzxzz.2025.12.008.

参考文献

[1] Wu XY, Shi JY, Buti J, et al.Buccal bone thickness and mid-facial soft tissue recession after various surgical approaches for immediate implant placement: a systematic review and network meta-analysis of controlled trials[J]. J Clin Periodontol, 2023,50(4):533-546. DOI: 10.1111/jcpe.13771.
[2] Araújo MG, Sukekava F, Wennström JL, et al.Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog[J]. J Clin Periodontol, 2005,32(6):645-652. DOI: 10.1111/j.1600-051X.2005.00726.x.
[3] Bakkali S, Rizo-Gorrita M, Romero-Ruiz MM, et al.Efficacy of different surgical techniques for peri-implant tissue preservation in immediate implant placement:a systematic review and meta-analysis[J]. Clin Oral Investig, 2021,25(4):1655-1675. DOI: 10.1007/s00784-021-03794-y.
[4] Garcia-Sanchez R, Dopico J, Kalemaj Z, et al.Comparison of clinical outcomes of immediate versus delayed placement of dental implants: a systematic review and meta-analysis[J]. Clin Oral Implants Res, 2022,33(3):231-277. DOI: 10.1111/clr.13892.
[5] Blanco J, Nuñez V, Aracil L, et al.Ridge alterations following immediate implant placement in the dog: flap versus flapless surgery[J]. J Clin Periodontol, 2008,35(7):640-648. DOI: 10.1111/j.1600-051X.2008. 01237.x.
[6] Ferrantino L, Camurati A, Gambino P, et al.Aesthetic outcomes of non-functional immediately restored single post-extraction implants with and without connective tissue graft: a multicentre randomized controlled trial[J]. Clin Oral Implants Res, 2021,32(6):684-694. DOI: 10.1111/clr.13733.
[7] Agarwal S, Sachdev SS, Mistry LN, et al.Soft tissue management in implant dentistry: a comprehensive review[J]. Cureus, 2025,17(2):e79557. DOI: 10.7759/cureus.79557.
[8] Mao Z, Lee CT, He SM, et al.Buccal bone dimensional changes at immediate implant sites in the maxillary esthetic zone within a 4-12-month follow-up period: a systematic review and meta-analysis[J]. Clin Implant Dent Relat Res, 2021,23(6):883-903. DOI: 10.1111/cid.13051.
[9] Chen ST, Buser D.Esthetic outcomes following immediate and early implant placement in the anterior maxilla--a systematic review[J]. Int J Oral Maxillofac Implants, 2014,29(Suppl):186-215. DOI: 10.11607/jomi.2014suppl.g3.3.
[10] Seyssens L, Eghbali A, Cosyn J.A 10-year prospective study on single immediate implants[J]. J Clin Periodontol, 2020,47(10):1248-1258. DOI: 10.1111/jcpe.13352.
[11] Hsu YT, Shieh CH, Wang HL.Using soft tissue graft to prevent mid-facial mucosal recession following immediate implant placement[J]. J Int Acad Periodontol, 2012,14(3):76-82.
[12] De Angelis P, Manicone PF, Rella E, et al.The effect of soft tissue augmentation on the clinical and radiographical outcomes following immediate implant placement and provisionalization: a systematic review and meta-analysis[J]. Int J Implant Dent, 2021,7(1):86. DOI: 10.1186/s40729-021-00365-4.
[13] Azadi A, Rezaei F, Yazdani A, et al.Hard and soft tissue alterations after the application of different soft tissue grafting materials during immediate dental implant placement: a systematic review and Bayesian network meta-analysis[J]. BMC Oral Health, 2025,25(1):183. DOI: 10.1186/s12903-025-05461-0.
[14] Jiang X, Di P, Ren S, et al.Hard and soft tissue alterations during the healing stage of immediate implant placement and provisionalization with or without connective tissue graft: a randomized clinical trial[J]. J Clin Periodontol, 2020,47(8):1006-1015. DOI: 10.1111/jcpe.13331.
[15] Zuiderveld EG, Meijer H, Gareb B, et al.Single immediate implant placement in the maxillary aesthetic zone with and without connective tissue grafting: results of a 5-year randomized controlled trial[J]. J Clin Periodontol, 2024,51(4):487-498. DOI: 10.1111/jcpe.13918.
[16] van Nimwegen WG, Raghoebar GM, Zuiderveld EG, et al. Immediate placement and provisionalization of implants in the aesthetic zone with or without a connective tissue graft: a 1-year randomized controlled trial and volumetric study[J]. Clin Oral Implants Res, 2018,29(7):671-678. DOI: 10.1111/clr.13258.
[17] Zuiderveld EG, van Nimwegen WG, Meijer H, et al. Effect of connective tissue grafting on buccal bone changes based on cone beam computed tomography scans in the esthetic zone of single immediate implants: a 1-year randomized controlled trial[J]. J Periodontol, 2021,92(4):553-561. DOI: 10.1002/JPER.20-0217.
[18] Fernandes D, Marques T, Borges T, et al.Volumetric analysis on the use of customized healing abutments with or without connective tissue graft at flapless maxillary immediate implant placement: a randomized clinical trial[J]. Clin Oral Implants Res, 2023,34(9):934-946. DOI: 10.1111/clr.14119.
[19] Lee CT, Tran D, Tsukiboshi Y, et al.Clinical efficacy of soft-tissue augmentation on tissue preservation at immediate implant sites: a randomized controlled trial[J]. J Clin Periodontol, 2023,50(7):1010-1020. DOI: 10.1111/jcpe.13816.
[20] Aldhohrah T, Qin G, Liang D, et al.Does simultaneous soft tissue augmentation around immediate or delayed dental implant placement using sub-epithelial connective tissue graft provide better outcomes compared to other treatment options? A systematic review and meta-analysis[J]. PLoS One, 2022,17(2):e0261513. DOI: 10.1371/journal.pone.0261513.
[21] Lambert F, Montero E, Laleman I, et al. Esthetic and patient-reported outcomes in immediate implants with adjunctive surgical procedures to increase soft tissue thickness/height: a systematic review[J]. Periodontol2000, 2025 Aug 12. DOI: 10.1111/prd.70003.[published online ahead of print].
[22] Seyssens L, De Lat L, Cosyn J.Immediate implant placement with or without connective tissue graft:a systematic review and meta-analysis[J]. J Clin Periodontol, 2021,48(2):284-301. DOI: 10.1111/jcpe.13397.
[23] Thoma DS, Cosyn J, Fickl S, et al.Soft tissue management at implants: summary and consensus statements of group 2. The 6th EAO Consensus Conference 2021[J]. Clin Oral Implants Res, 2021,32(Suppl 21):174-180. DOI: 10.1111/clr.13798.
[24] Raghoebar GM, Korfage A, Meijer H, et al.Linear and profilometric changes of the mucosa following soft tissue augmentation in the zone of aesthetic priority: a systematic review and meta-analysis[J]. Clin Oral Implants Res, 2021,32(Suppl 21):138-156. DOI: 10.1111/clr.13759.
[25] Noelken R, Moergel M, Pausch T, et al.Clinical and esthetic outcome with immediate insertion and provisionalization with or without connective tissue grafting in presence of mucogingival recessions: a retrospective analysis with follow-up between 1 and 8 years[J]. Clin Implant Dent Relat Res, 2018,20(3):285-293. DOI: 10.1111/cid.12595.
[26] Jung RE, Heitz-Mayfield L, Schwarz F, et al.Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus report part 3-aesthetics of peri-implant soft tissues[J]. Clin Oral Implants Res, 2018,29(Suppl 15):14-17. DOI: 10.1111/clr.13113.
[27] Giannobile WV, Jung RE, Schwarz F, et al.Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus report part 1-effects of soft tissue augmentation procedures on the maintenance of peri-implant soft tissue health[J]. Clin Oral Implants Res, 2018,29(Suppl 15):7-10. DOI: 10.1111/clr.13110.
[28] Fettouh A, Ghallab NA, Mina NA, et al.Hard and soft tissue alterations using dual-zone concept versus connective tissue graft at maxillary immediate implant placement:a 1-year randomized clinical and volumetric trial[J]. Clin Oral Implants Res, 2024,35(5):510-525. DOI: 10.1111/clr.14247.
[29] Fürhauser R, Florescu D, Benesch T, et al.Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score[J]. Clin Oral Implants Res, 2005,16(6):639-644. DOI: 10.1111/j.1600-0501.2005.01193.x.
[30] Belser UC, Grütter L, Vailati F, et al.Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores[J]. J Periodontol, 2009,80(1):140-151. DOI: 10.1902/jop.2009.080435.
[31] Azaripour A, Sagheb K, Stock L, et al.The use of a soft tissue substitute at immediate postextractive implants to reduce tissue shrinkage: one-year results from a randomized controlled trial[J]. Int J Periodontics Restorative Dent, 2023,43(4):463-469. DOI: 10.11607/prd.5620.
[32] Happe A, Schmidt A, Neugebauer J.Peri-implant soft-tissue esthetic outcome after immediate implant placement in conjunction with xenogeneic acellular dermal matrix or connective tissue graft: a randomized controlled clinical study[J]. J Esthet Restor Dent, 2022,34(1):215-225. DOI: 10.1111/jerd.12866.
[33] Frizzera F, de Freitas RM, Muñoz-Chávez OF, et al. Impact of soft tissue grafts to reduce peri-implant alterations after immediate implant placement and provisionalization in compromised sockets[J]. Int J Periodontics Restorative Dent, 2019,39(3):381-389. DOI: 10.11607/prd.3224.
[34] Rojo E, Stroppa G, Sanz-Martin I, et al.Soft tissue stability around dental implants after soft tissue grafting from the lateral palate or the tuberosity area - a randomized controlled clinical study[J]. J Clin Periodontol, 2020,47(7):892-899. DOI: 10.1111/jcpe.13292.
[35] Zucchelli G, Tavelli L, McGuire MK, et al. Autogenous soft tissue grafting for periodontal and peri-implant plastic surgical reconstruction[J]. J Periodontol, 2020,91(1):9-16. DOI: 10.1002/JPER.19-0350.
[36] Nevins M, Nevins ML, Kim SW, et al.The use of mucograft collagen matrix to augment the zone of keratinized tissue around teeth: a pilot study[J]. Int J Periodontics Restorative Dent, 2011,31(4):367-373.
[37] Jung RE, Hürzeler MB, Thoma DS, et al.Local tolerance and efficiency of two prototype collagen matrices to increase the width of keratinized tissue[J]. J Clin Periodontol, 2011,38(2):173-179. DOI: 10.1111/j.1600-051X.2010.01640.x.
[38] Thoma DS, Naenni N, Benic GI, et al.Soft tissue volume augmentation at dental implant sites using a volume stable three-dimensional collagen matrix - histological outcomes of a preclinical study[J]. J Clin Periodontol, 2017,44(2):185-194. DOI: 10.1111/jcpe.12635.
[39] Puisys A, Deikuviene J, Vindasiute-Narbute E, et al.Connective tissue graft vs porcine collagen matrix after immediate implant placement in esthetic area:a randomized clinical trial[J]. Clin Implant Dent Relat Res, 2022,24(2):141-150. DOI: 10.1111/cid.13058.
[40] Boháč M, Danišovič Ľ, Koller J, et al.What happens to an acellular dermal matrix after implantation in the human body? A histological and electron microscopic study[J]. Eur J Histochem, 2018,62(1):2873. DOI: 10.4081/ejh.2018.2873.
[41] Tavelli L, McGuire MK, Zucchelli G, et al. Extracellular matrix-based scaffolding technologies for periodontal and peri-implant soft tissue regeneration[J]. J Periodontol, 2020,91(1):17-25. DOI: 10.1002/JPER.19-0351.
[42] Tommasato G, Del Fabbro M, Oliva N, et al.Autogenous graft versus collagen matrices for peri-implant soft tissue augmentation. A systematic review and network meta-analysis[J]. Clin Oral Investig, 2024,28(5):300. DOI: 10.1007/s00784-024-05684-5.
[43] Galve-Huertas A, Decadt L, García-González S, et al.Immediate implant placement with soft tissue augmentation using acellular dermal matrix versus connective tissue graft: a systematic review and meta-analysis[J]. Materials (Basel), 2024,17(21):5285. DOI: 10.3390/ma17215285.
[44] Sanz M, Schwarz F, Herrera D, et al.Importance of keratinized mucosa around dental implants: consensus report of group 1 of the DGI/SEPA/Osteology Workshop[J]. Clin Oral Implants Res, 2022, 33(Suppl 23): 47-55. DOI: 10.1111/clr.13956.
[45] Stefanini M, Rendón A, Zucchelli A, et al.Avoiding errors and complications related to immediate implant placement in the esthetic area with a mucogingival approach[J]. Periodontol 2000, 2023,92(1):362-372. DOI: 10.1111/prd.12491.
[46] Pitman J, Seyssens L, Christiaens V, et al.Immediate implant placement with or without immediate provisionalization:a systematic review and meta-analysis[J]. J Clin Periodontol, 2022,49(10):1012-1023. DOI: 10.1111/jcpe.13686.
[47] Su H, Gonzalez-Martin O, Weisgold A, et al.Considerations of implant abutment and crown contour: critical contour and subcritical contour[J]. Int J Periodontics Restorative Dent, 2010,30(4):335-343.
[48] Siegenthaler M, Strauss FJ, Gamper F, et al.Anterior implant restorations with a convex emergence profile increase the frequency of recession: 12-month results of a randomized controlled clinical trial[J]. J Clin Periodontol, 2022,49(11):1145-1157. DOI: 10.1111/jcpe.13696.
[49] González-Martín O, Lee E, Weisgold A, et al.Contour management of implant restorations for optimal emergence profiles: guidelines for immediate and delayed provisional restorations[J]. Int J Periodontics Restorative Dent, 2020,40(1):61-70. DOI: 10.11607/prd.4422.
[50] Zuhr O, Rebele SF, Cheung SL, et al.Surgery without papilla incision: tunneling flap procedures in plastic periodontal and implant surgery[J]. Periodontol 2000, 2018,77(1):123-149. DOI: 10.1111/prd.12214.

即刻种植同期行软组织增量手术的临床效果与考量

Clinical outcomes and considerations of concurrent soft tissue augmentation with immediate implant placement

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