种植体周围软组织的临床意义和研究进展

doi:10.3969/j.issn.1005-4979.2019.02.009

摘要/Abstract

摘要： 种植体周围软组织不仅影响种植体的远期稳定性，同时也对唇颊侧的美观性起着决定性的作用。种植体周围角化龈宽度可以减少菌斑的堆积和局部牙槽嵴的吸收，减少软组织的退缩；具有一定厚度的黏膜同样会对牙槽嵴形成保护，增加种植周围水平方向和垂直方向的美学评分。目前对软组织的研究主要是角化龈宽度，对黏膜厚度的研究较少，本文将对种植体周围软组织对种植体的远期稳定性以及红色美学评分的影响作一综述。

关键词: 种植牙, 角化龈, 软组织厚度, 生物学宽度, 红色美学

Abstract: The soft tissue around the implant not only affects the long-term stability of the implant but also plays a decisive role in the pink esthetic score (PES). The width of the attached gingival reduce the accumulation of plaque and the absorption of the alveolar ridge, and mucosal recession. Mucosal thickness also protects the alveolar ridge and increases the PES of the horizontal and vertical directions around the implant. The need for keratinized mucosa or thick mucosa is a controversial topic. In this review, we describe the effects of the soft tissue around peri-implant on the long-term stability of implants and the PES.

Key words: dental implant；keratinized mucosa；soft tissue thickness；biologic width, pink esthetic score (PES)

中图分类号:

赵萌（综述）, 高益鸣（审校）. 种植体周围软组织的临床意义和研究进展[J]. 《口腔颌面外科杂志》, doi: 10.3969/j.issn.1005-4979.2019.02.009.

ZHAO Meng, GAO Yi-ming. Clinical significance and research progress of peri-implant soft tissue[J]. 《Journal of Oral and Maxillofacial Surgery》, doi: 10.3969/j.issn.1005-4979.2019.02.009.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2019/V29/I2/105

参考文献

[1] Ivanovski S, Lee R. Comparison of peri-implant and periodontal marginal soft tissues in health and disease [J]. Periodontol 2000, 2018, 76(1): 116-130.

[2] Moraschini V, Luz D, Velloso G, et al. Quality assessment of systematic reviews of the significance of keratinized mucosa on implant health [J]. Int J Oral Maxillofac Surg, 2017, 46(6): 774-781.

[3] Eghbali A, Seyssens L, De Bruyckere T, et al. A 5-year prospective study on the clinical and aesthetic outcomes of alveolar ridge preservation and connective tissue graft at the buccal aspect of single implants [J]. J Clin Periodontol, 2018, 45(12): 1475-1484.

[4] 靳夏莹. 美学区域即刻种植中红色美学效果的影响因素 [J]. 中国口腔种植学杂志, 2018, 23(2): 87-92.

[5] Lee DJ, Ryu JS, Shimono M, et al. Differential Healing Patterns of Mucosal Seal on Zirconia and Titanium Implant [J]. Front Physiol, 2019, 10:796.

[6] Bassetti RG, Stahli A, Bassetti MA, et al. Soft tissue augmentation procedures at second-stage surgery: a systematic review [J]. Clin Oral Investig, 2016, 20(7): 1369-1387.

[7] Takamori Y, Atsuta I, Nakamura H, et al. Histopathological comparison of the onset of peri-implantitis and periodontitis in rats [J]. Clin Oral Implants Res, 2017, 28(2): 163-170.

[8] Ladwein C, Schmelzeisen R, Nelson K, et al. Is the presence of keratinized mucosa associated with periimplant tissue health? A clinical cross-sectional analysis [J]. Int J Implant Dent, 2015, 1(1): 11.

[9] Lin GH, Chan HL, Wang HL. Effects of currently available surgical and restorative interventions on reducing midfacial mucosal recession of immediately placed single-tooth implants: a systematic review [J]. J Periodontol, 2014, 85(1): 92-102.

[10] Frisch E, Ziebolz D, Vach K, et al. The Effect of Keratinized Mucosa Width on Peri-Implant Outcome under Supportive Postimplant Therapy [J]. Clinical Implant Dentistry and Related Research, 2015, 17(Suppl1) :E236-E244.

[11] Wada M, Mameno T, Onodera Y, et al. Prevalence of peri-implant disease and risk indicators in a Japanese population with at least 3 years in function-A multicentre retrospective study [J]. Clin Oral Implants Res, 2019, 30(2): 111-120.

[12] Perussolo J, Souza AB, Matarazzo F, et al. Influence of the keratinized mucosa on the stability of peri-implant tissues and brushing discomfort: A 4-year follow-up study [J]. Clin Oral Implants Res, 2018, 29(12): 1177-1185.

[13] Roccuzzo M, Grasso G, Dalmasso P. Keratinized mucosa around implants in partially edentulous posterior mandible: 10-year results of a prospective comparative study [J]. Clin Oral Implants Res, 2016, 27(4): 491-496.

[14] Pranskunas M, Poskevicius L, Juodzbalys G, et al. Influence of Peri-Implant Soft Tissue Condition and Plaque Accumulation on Peri-Implantitis: a Systematic Review [J]. J Oral Maxillofac Res, 2016, 7(3): e2.

[15] Thoma DS, Naenni N, Figuero E, et al. Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis [J]. Clin Oral Implants Res, 2018, 29 (Suppl 15):32-49.

[16] Vignoletti F, Di Domenico GL, Di Martino M, et al. Prevalence and risk indicators of peri-implantitis in a sample of university-based dental patients in Italy: A cross-sectional study [J]. J Clin Periodontol, 2019, 46(5): 597-605.

[17] Wennstrom 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(Suppl6) :136-146.

[18] Grischke J, Karch A, Wenzlaff A, et al. Keratinized mucosa width is associated with severity of peri-implant mucositis. A cross-sectional study [J]. Clin Oral Implants Res, 2019, 30(5): 457-465.

[19] Schwarz F, Becker J, Civale S, et al. Influence of the width of keratinized tissue on the development and resolution of experimental peri-implant mucositis lesions in humans [J]. Clin Oral Implants Res, 2018, 29(6): 576-582.

[20] Al Ghazal L, O'sullivan J, Claffey N, et al. Comparison of two different techniques used for the maintenance of peri-implant soft tissue health: a pilot randomized clinical trial [J]. Acta Odontol Scand, 2017, 75(7): 542-549.

[21] Boynuegri 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.

[22] Lim HC, Wiedemeier DB, Hämmerle CHF, et al. The amount of keratinized mucosa may not influence peri-implant health in compliant patients: A retrospective 5-year analysis [J]. J Clin Periodontol, 2019, 46(3): 354-362.

[23] Vellis J, Kutkut A, Al-Sabbagh M. Comparison of Xenogeneic Collagen Matrix vs. Free Gingival Grafts to Increase the Zone of Keratinized Mucosa Around Functioning Implants [J]. Implant Dentistry, 2019, 28(1): 20-27.

[24] 孟逍逸, 薛毅. 前牙美学区种植的软组织增量研究进展 [J]. 口腔颌面修复学杂志, 2018, 19(1): 59-64.

[25] 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): e24-28.

[26] Brito C, Tenenbaum HC, Wong BKC, et al. Is keratinized mucosa indispensable to maintain peri-implant health? A systematic review of the literature [J]. Journal of Biomedical Materials Research Part B-Applied Biomaterials, 2014, 102(3): 643-650.

[27] Bassetti RG, Stahli A, Bassetti MA, et al. Soft tissue augmentation around osseointegrated and uncovered dental implants: a systematic review [J]. Clin Oral Investig, 2017, 21(1): 53-70.

[28] Cairo F, Pagliaro U, Nieri M. Soft tissue management at implant sites [J]. Journal of Clinical Periodontology, 2008, 35(Suppl8) :163-167.

[29] Fickl S. Peri-implant mucosal recession: Clinical significance and therapeutic opportunities [J]. Quintessence Int, 2015, 46(8): 671-676.

[30] Rotundo R, Pagliaro U, Bendinelli E, et al. Long-term outcomes of soft tissue augmentation around dental implants on soft and hard tissue stability: a systematic review [J]. Clin Oral Implants Res, 2015, 26 (Suppl11):123-138.

[31] Oh SL, Masri RM, Williams DA, et al. Free gingival grafts for implants exhibiting lack of keratinized mucosa: a prospective controlled randomized clinical study [J]. J Clin Periodontol, 2017, 44(2): 195-203.

[32] Wilcko MT, Ferguson DJ, Makki L, et al. Keratinized Gingiva Height Increases After Alveolar Corticotomy and Augmentation Bone Grafting [J]. J Periodontol, 2015, 86(10): 1107-1115.

[33] Lin G-H, Chan H-L, Wang H-L. The Significance of Keratinized Mucosa on Implant Health: A Systematic Review [J]. Journal of Periodontology, 2013, 84(12): 1755-1767.

[34] 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]. Clinical Implant Dentistry and Related Research, 2015, 17(6): 1228-1236.

[35] Linkevicius T, Puisys A, Linkeviciene L, et al. Crestal Bone Stability around Implants with Horizontally Matching Connection after Soft Tissue Thickening: A Prospective Clinical Trial [J]. Clin Implant Dent Relat Res, 2015, 17(3): 497-508.

[36] Zuiderveld EG, Meijer HJA, Den Hartog L, et al. Effect of connective tissue grafting on peri-implant tissue in single immediate implant sites: A RCT [J]. J Clin Periodontol, 2018, 45(2): 253-264.

[37] De Siqueira RaC, Fontao F, Sartori IaM, et al. Effect of different implant placement depths on crestal bone levels and soft tissue behavior: a randomized clinical trial [J]. Clin Oral Implants Res, 2017, 28(10): 1227-1233.

[38] 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.

[39] Raes S, Eghbali A, Chappuis V, et al. A long-term prospective cohort study on immediately restored single tooth implants inserted in extraction sockets and healed ridges: CBCT analyses, soft tissue alterations, aesthetic ratings, and patient-reported outcomes [J]. Clin Implant Dent Relat Res, 2018, 20(4): 522-530.

[40] Aglietta M, Siciliano VI, Rasperini G, et al. A 10-year retrospective analysis of marginal bone-level changes around implants in periodontally healthy and periodontally compromised tobacco smokers [J]. Clinical Oral Implants Research, 2011, 22(1): 47-53.

[41] Linkevicius T, Linkevicius R, Alkimavicius J, et al. Influence of titanium base, lithium disilicate restoration and vertical soft tissue thickness on bone stability around triangular-shaped implants: A prospective clinical trial [J]. Clin Oral Implants Res, 2018, 29(7): 716-724.

[42] Van Eekeren P, Van Elsas P, Tahmaseb A, et al. The influence of initial mucosal thickness on crestal bone change in similar macrogeometrical implants: a prospective randomized clinical trial [J]. Clinical Oral Implants Research, 2017, 28(2): 214-218.

[43] Linkevicius T, Apse P, Grybauskas S, et al. Influence of thin mucosal tissues on crestal bone stability around implants with platform switching: a 1-year pilot study [J]. J Oral Maxillofac Surg, 2010, 68(9): 2272-2277.

[44] Puisys A, Linkevicius T. The influence of mucosal tissue thickening on crestal bone stability around bone-level implants. A prospective controlled clinical trial [J]. Clinical Oral Implants Research, 2015, 26(2): 123-129.

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