种植体周角化龈不足的风险因素及临床处理策略

Risk factors and clinical management strategies for insuf ficient keratinized mucosa around dental implants

种植体周围软组织不仅影响种植体的长期稳定性,对唇颊区的美学表现及患者适应性也起到决定性的作用。种植体周围足量的角化龈宽度可减少菌斑堆积及局部牙槽嵴的吸收,降低种植体周围炎的发生率。因此,规避角化龈不足的风险、掌握不同的角化龈处理及增量方法有助于及时有效地治疗临床出现的并发症。目前,临床中用于角化龈增宽的术式主要有根向复位瓣术、游离龈移植术及上皮下结缔组织移植术等。文章旨在介绍种植体周角化龈宽度不足的风险因素及各类角化龈增宽手术的临床操作要点,以期为临床诊疗提供参考。

The peri-implant soft tissue not only influences the long-term stability of the implant,but also plays a decisive role in the aesthetics of the labial and buccal sides as well as in patient adaptation.Adequate keratinized mucosa width around the implant reduces plaque accumulation and local alveolar ridge resorption,and decreases the incidence of peri-implantitis.Therefore,avoiding the risk of insufficient keratinized mucosa and mastering different methods of keratinized mucosa treatment and augmentation can contribute to the timely and effective treatment of clinical complications.Currently,the main surgical procedures used for keratinized mucosa widening in the clinic include root-oriented resurfacing flap,free gingival grafting,and subepithelial connective tissue grafting.In this article,we present a review of the risk factors for insufficient width of peri-implant keratinized mucosa and the operational features of various types of keratinized mucosa widening procedures,with a view to provide reference for clinical diagnosis and treatment.