下颌后牙区种植修复前行角化黏膜增宽术的时机考量及临床体会

doi:10.12337/zgkqzzxzz.2024.12.017

中国口腔种植学杂志 ›› 2025, Vol. 29 ›› Issue (6): 568-573.DOI: 10.12337/zgkqzzxzz.2024.12.017

下颌后牙区种植修复前行角化黏膜增宽术的时机考量及临床体会

郭一馨¹, 夏薇², 王侗飞³, 王君婷², 皮甜甜², 邓荣纳², 梁美琦², 容明灯², 曾艳²

¹深圳市龙岗区骨科医院口腔科,深圳 518116;
²南方医科大学口腔医院特诊中心,广州 510280;
³南方医科大学深圳口腔医院（坪山）牙周黏膜病科 518118

收稿日期:2024-07-09 出版日期:2025-01-02 发布日期:2025-01-02
通讯作者: 容明灯,Email：rmdeng@smu.edu.cn,电话：020-84424827;曾艳,Email：825992090@qq.com,电话：020-84424827
作者简介:郭一馨主治医师,研究方向：口腔种植学及牙周病学;容明灯博士、主任医师、博士生导师/博士后合作导师,研究方向：口腔种植修复、种植体周炎的防治;曾艳护士长、主管护师,研究方向：口腔种植修复相关的护理临床研究

Timing considerations and clinical insights for attached gingival augmentation before implant restoration in the mandibular posterior region

Guo Yixin¹, Xia Wei², Wang Tongfei³, Wang Junting², Pi Tiantian², Deng Rongna², Liang Meiqi², Rong Mingdeng², Zeng Yan²

¹Department of Stomatology, Longgang District Orthopedics Hospital of Shenzhen, Shenzhen 518116, China;
²Department of Vip, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China;
³Department of Periodontal and Mucosal Diseases, Shenzhen Stomatology Hospital(Pingshan)of Southern Medical University, Shenzhen 518118, China

Received:2024-07-09 Online:2025-01-02 Published:2025-01-02
Contact: Rong Mingdeng, Email: rmdeng@smu.edu.cn, Tel: 0086-20-84424827; Zeng Yan, Email: 825992090@qq.com, Tel: 0086-20-84424827

摘要/Abstract

摘要： 种植体周围充足的角化黏膜对于维持种植修复的长期效果是十分必要的,临床上游离龈移植作为种植体周角化黏膜增宽的金标准被广泛应用,但对手术时机的选择并没有明确定论。笔者选择种植前及种植同期对下颌后牙区行角化黏膜增宽术,均获得了良好的治疗效果。其中后者运用数字化导板,不翻瓣下将种植体植入与角化黏膜增宽手术同期进行,手术效果可预期,减少了手术次数,减轻了患者痛苦,提高了临床诊疗效率,可为临床上同类型病例提供参考。

关键词: 数字化导板, 口腔种植, 角化黏膜增宽术, 手术时机

Abstract: Adequate attached gingiva around implants is essential for maintaining the long-term success of implant restoration. Clinically, free gingival grafts are widely recognized as the gold standard for augmenting peri-implant attached gingiva, but there is no clear consensus regarding the optimal timing of surgery. This study explores two approaches for attached gingiva augmentation in the posterior mandibular region: prior to implant placement and simultaneously with implant placement. Both approaches demonstrated favorable outcomes. In the latter approach, a digital surgical guide was used to facilitate simultaneous implant placement and attached gingiva augmentation without flap elevation, resulting in predictable outcomes, fewer surgical interventions, reduced patient discomfort, and enhanced clinical efficiency. These findings provide a valuable reference for similar cases in clinical practice.

Key words: Digital surgical guides, Dental implant placement, Attached gingiva augmentation, Timing of surgery guides

郭一馨,夏薇,王侗飞,等. 下颌后牙区种植修复前行角化黏膜增宽术的时机考量及临床体会[J]. 中国口腔种植学杂志, 2025, 29(6): 568-573. DOI: 10.12337/zgkqzzxzz.2024.12.017

Guo Yixin, Xia Wei, Wang Tongfei, Wang Junting, Pi Tiantian, Deng Rongna, Liang Meiqi, Rong Mingdeng, Zeng Yan. Timing considerations and clinical insights for attached gingival augmentation before implant restoration in the mandibular posterior region[J].Chinese Journal of Oral Implantology, 2025, 29(6): 568-573.DOI: 10.12337/zgkqzzxzz.2024.12.017.

参考文献

[1] Chackartchi T, Romanos GE, Sculean A.Soft tissue-related complications and management around dental implants[J]. Periodontol 2000, 2019,81(1):124-138. DOI: 10.1111/prd.12287.
[2] Lang NP, Löe H.The relationship between the width of keratinized gingiva and gingival health[J]. J Periodontol, 1972,43(10):623-627. DOI: 10.1902/jop.1972.43.10.623.
[3] Linkevicius T, Puisys A, Steigmann M, et al.Influence of vertical soft tissue thickness on crestal bone changes around implants with platform switching: a comparative clinical study[J]. Clin Implant Dent Relat Res, 2015,17(6):1228-1236. DOI: 10.1111/cid.12222.
[4] Kim BS, Kim YK, Yun PY, et al.Evaluation of peri-implant tissue response according to the presence of keratinized mucosa[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009,107(3):e24-e28. DOI: 10.1016/j.tripleo.2008.12.010.
[5] Thoma DS, Gil A, Hämmerle C, et al.Management and prevention of soft tissue complications in implant dentistry[J]. Periodontol 2000, 2022,88(1):116-129. DOI: 10.1111/prd.12415.
[6] Esposito M, Maghaireh H, Grusovin MG, et al.Soft tissue management for dental implants: what are the most effective techniques? A Cochrane systematic review[J]. Eur J Oral Implantol, 2012,5(3):221-238.
[7] 徐淑兰,李平,杨烁,等.数字化种植导板手术的精确性:非手术因素分析及对策的专家共识[J].口腔疾病防治, 2024, 32(5):321-329.DOI:10.12016/j.issn.2096-1456. 2024.05.001.
[8] Lin GH, Chan HL, Wang HL.The significance of keratinized mucosa on implant health: a systematic review[J]. J Periodontol, 2013,84(12):1755-1767. DOI: 10.1902/jop.2013.120688.
[9] Warrer K, Buser D, Lang NP, et al.Plaque-induced peri-implantitis in the presence or absence of keratinized mucosa. An experimental study in monkeys[J]. Clin Oral Implants Res, 1995,6(3):131-138. DOI: 10.1034/j.1600-0501.1995.060301.x.
[10] Buyukozdemir Askin S, Berker E, Akincibay H, et al.Necessity of keratinized tissues for dental implants: a clinical, immunological, and radiographic study[J]. Clin Implant Dent Relat Res, 2015,17(1):1-12. DOI: 10.1111/cid.12079.
[11] Wennström JL, Derks J .Is there a need for keratinized mucosa around implants to maintain health and tissue stability?[J].Clinical Oral Implants Research, 2012, 23(Supp l6):S136-S146.DOI:10.1111/j.1600-0501.2012.02540.x.
[12] Poskevicius L, Sidlauskas A, Galindo-Moreno P, et al.Dimensional soft tissue changes following soft tissue grafting in conjunction with implant placement or around present dental implants: a systematic review[J]. Clin Oral Implants Res, 2017,28(1):1-8. DOI: 10.1111/clr.12606.
[13] Bengazi F, Lang NP, Caroprese M, et al.Dimensional changes in soft tissues around dental implants following free gingival grafting: an experimental study in dogs[J]. Clin Oral Implants Res, 2015,26(2):176-182. DOI: 10.1111/clr.12280.
[14] Boynueğri D, Nemli SK, Kasko YA.Significance of keratinized mucosa around dental implants: a prospective comparative study[J]. Clin Oral Implants Res, 2013,24(8):928-933. DOI: 10.1111/j.1600-0501.2012.02475.x.
[15] 景雪琴,苗辉.附着龈增宽临床研究现状[J].口腔医学研究, 2024, 40(2):97-102. DOI:10.13701/j.cnki.kqyxyj. 2024.02. 001.
[16] Basegmez C, Ersanli S, Demirel K, et al.The comparison of two techniques to increase the amount of peri-implant attached mucosa: free gingival grafts versus vestibuloplasty.one-year results from a randomised controlled trial[J]. European Journal of Oral Implantology, 2012, 5(2): 139-146. DOI: 10.1111/j.1752-7325.2012.00332.x.
[17] Schmitt CM, Moest T, Lutz R, et al.Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft(®) ) versus the free gingival graft: a comparative prospective clinical trial[J]. Clin Oral Implants Res, 2016,27(11):e125-e133. DOI: 10.1111/clr.12575.
[18] 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):S174-S180. DOI: 10.1111/clr.13798.
[19] Chackartchi T, Romanos GE, Sculean A.Soft tissue-related complications and management around dental implants[J]. Periodontol 2000, 2019,81(1):124-138. DOI: 10.1111/prd.12287.
[20] 容明灯, 黄雁红, 卢海宾, 等. 显微牙周外科技术在种植体周附着龈增宽术中的应用[J].华西口腔医学杂志, 2018,36(1):71-75. DOI: 10.7518/hxkq.2018.01.014.
[21] 陈东红,译. Sclar AG. 软组织与美容考虑在种植治疗中的应用[M]. 北京:人民军医出版社,2009.
[22] Barone A, Toti P, Piattelli A, et al.Extraction socket healing in humans after ridge preservation techniques: comparison between flapless and flapped procedures in a randomized clinical trial[J]. J Periodontol, 2014,85(1):14-23. DOI: 10.1902/jop.2013.120711.
[23] 游杰, 闫文娟, 林丽婷, 等. 数字化口内扫描技术专家共识[J].口腔疾病防治,2024,32(8):569-577. DOI: 10.12016/j.issn.2096-1456.2024.08.001.

下颌后牙区种植修复前行角化黏膜增宽术的时机考量及临床体会

Timing considerations and clinical insights for attached gingival augmentation before implant restoration in the mandibular posterior region

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	杨爱芬, 周立伟. 数字化导板在牙周炎患者全口即刻种植中的应用[J]. 中国口腔种植学杂志, 2025, 29(6): 585-589.
[2]	李健, 梁晔, 赵保东. 金属有机框架材料在口腔医学领域的研究进展[J]. 中国口腔种植学杂志, 2025, 29(6): 602-609.
[3]	李福龙, 邓宇, 田思睿, 高静, 赵宝红. 布鲁姆目标分类理论在口腔种植学住院医师规范化培训中的应用[J]. 中国口腔种植学杂志, 2025, 29(6): 610-615.
[4]	高明, 牛力璇, 朱一博. 应用自体牙本质块行骨增量的临床和组织学研究[J]. 中国口腔种植学杂志, 2024, 29(5): 435-439.
[5]	杜奥博, 满毅. 美学区分阶段骨增量联合邻牙显微根尖手术的治疗策略：临床诊治流程及实践病例[J]. 中国口腔种植学杂志, 2024, 29(5): 440-444.
[6]	柴浩然, 刘艺, 王尊硕, 郎哲宇, 李晨辉, 朱升辉, 张学普, 张月. 辽宁5市中老年牙缺失患者对口腔种植意愿及相关因素的调查[J]. 中国口腔种植学杂志, 2024, 29(5): 467-473.
[7]	戴雨薇, 兰嵘, 吴轶群, 王凤. 牙槽突裂患者的牙种植治疗现状与研究进展[J]. 中国口腔种植学杂志, 2024, 29(5): 486-491.
[8]	白轶, 柴纪华, 张晓欣, 夏婷, 曾浩. SAC分类在口腔种植规培教学中的探索与实践[J]. 中国口腔种植学杂志, 2024, 29(5): 498-501.
[9]	汤祎熳, 邱立新. 器官移植患者接受种植治疗时的临床思考[J]. 中国口腔种植学杂志, 2024, 29(4): 297-302.
[10]	赵国强, 宋应亮. 2型糖尿病个体进行即刻种植即刻修复预后的动物实验研究[J]. 中国口腔种植学杂志, 2024, 29(4): 311-319.
[11]	张燕婷, 汪伟, 陈莉, 赵雯, 周炜. ASA Ⅲ级心血管疾病患者口腔种植修复的围手术期风险评估与管理[J]. 中国口腔种植学杂志, 2024, 29(4): 328-335.
[12]	邱韵, 王宇蓝, 张玉峰. 骨质疏松症对牙种植的影响及临床考量[J]. 中国口腔种植学杂志, 2024, 29(4): 336-341.
[13]	王一茗, 李昕茹, 滕微微, 马骏驰, 周立波. 口腔种植机器人在临床前及临床研究应用精度的Meta分析[J]. 中国口腔种植学杂志, 2024, 29(4): 362-370.
[14]	李歆, 刘开政, 武诗语, 刘远翔, 黄宝鑫, 乔威, 潘浩波, 陈卓凡. 口腔种植治疗中骨再生材料的研究现状[J]. 中国口腔种植学杂志, 2024, 29(4): 371-377.
[15]	陈江, 丘雨蓓. 数字化技术在口腔种植骨增量中的应用及研究进展[J]. 中国口腔种植学杂志, 2024, 29(3): 252-257.