Papillae alterations around single-implant restorations in the anterior maxillae:thick versus thin mucosa

To evaluate the papilla alterations around single-implant restorations in the anterior maxillae after crown attachment and to study the influence of soft tissue thickness on the papilla fill alteration. According to the inclusion criteria, 32 patients subjected to implant-supported single-tooth restorations in anterior maxillae were included. The patients were assigned to two groups according to the mucosal thickness： （i） group 1, 1.5 mm≤mucosal thickness≤3 mm; and （ii） group 2, 3 mm〈mucosal thickness≤4.5 mm. Assessments of interproximal papillae at the time of crown placement （baseline） and at 6-month postloading （follow-up） were made by two prosthodontists using papilla fill index （PFI）. The mean mucosal thickness was （2.49±0.31） mm （group 1） and （3.81±0.31） mm （group 2） for the two groups respectively. A significant difference in PFI between the groups was detected at the baseline （P〈O.O01）. PFI improvements over time occurred after 6-month follow-up irrespective of the groups. When compared to group 1, the likelihood to obtain papilla fill was significantly higher for group 2 with an odds ratio of 6.05 （P〈O.O01）. The interproximal papilla level around single-implant restorations could improve significantly over time after 6-month restoration according to PFI assessment. The thicker mucosa before implant placement implied a more favorable esthetic outcome in papilla alteration.

牙龈瘤翻瓣切除术与常规切除术的疗效比较

目的:探讨牙龈瘤翻瓣切除术对于常规切除术的疗效比较与分析。方法:纳入牙龈瘤患者48例,随机分为2组,实验组25例,采用局部翻瓣切除瘤体,微创骨修整后缝合;对照组23例,采用传统牙龈瘤切除术。比较两组复发率,术后疼痛、牙龈形态,所得数据经SPSS 19.0软件系统分析。结果:2组患者术后1年2组均无复发,实验组较对照组牙龈退缩少(P<0.05),龈乳头丰满度好(P<0.05),附着龈增加更明显(P<0.05);疼痛减轻快,且疼痛程度更小(P<0.05)。结论:牙龈瘤翻瓣切除术较常规切除术术区不适轻,术后牙龈形态恢复好。

冠延长术后PMMA临时冠诱导龈乳头形成的作用研究

目的:评价聚甲基丙烯酸甲酯(polymethylmethacrylate,PMMA)临时冠在冠延长术后应用,引导龈乳头生长的临床效果。方法:选出21名患者,共75颗患牙,牙周基础治疗及根管治疗(如有必要)后,行冠延长术。术后2周行PMMA临时冠修复。记录术后2周、术后3、6个月龈乳头高度及龈乳头充盈指数。结果:术后2周、术后3、6个月龈乳头高度平均值分别是:(2.59±0.35)mm,(3.64±0.36)mm,(4.38±0.25)mm,3个时间段间差异均具有显著性(P<0.05)。3组龈乳头充盈指数经ridit分析,R值置信区间分别为(0.154,0.270)、(0.465,0.581)、(0.707,0.823),3组间差异均具有显著性(P<0.05)。结论:PMMA临时冠在冠延长术后应用,能诱导龈乳头再生,使得龈乳头充盈指数显著增加,有效地避免了永久修复后黑三角及牙龈红肿的出现。

牙龈生物学类型对上颌单牙种植后龈乳头美学效果的影响

目的评估牙龈生物学类型对上颌前牙区单牙种植修复后龈乳头美学效果的影响。方法 32例上颌前牙区单牙缺失的患者,按软组织厚度分组,Ⅰ组:16例,厚度1.5 mm^3 mm;Ⅱ组:16例,厚度3.1 mm^4.5 mm。共植入32枚ITI种植体,术后2~3个月常规修复,于修复完成当日(基线期)和6个月后(随访期),应用龈乳头充填指数(PFI)评估种植体周围龈乳头形态。比较基线期和随访期各组PFI变化,并进行统计学检验。结果观察期内两组均无种植体松动脱落。两组在随访期的PFI均显著高于基线期(P<0.05),Ⅱ组在基线期的PFI显著高于Ⅰ组(P<0.05),两组之间的PFI变化有显著性差异(P<0.05)。结论牙龈生物学类型是影响种植修复后龈乳头美学的重要因素,软组织较厚者龈乳头美学效果更好。

超薄瓷贴面关闭前牙间隙诱导牙龈乳头形成研究

目的:评价超薄瓷贴面在关闭不同大小前牙间隙时诱导牙龈乳头形成临床效果。方法:将上中切牙间隙患者按照间隙大小<2 mm(n=38)和≥2 mm(n=21)分为A、B共两组。采用超薄瓷贴面关闭前牙间隙,并预留牙龈乳头间隙诱导牙龈乳头形成,分别记录术后即刻、2周、3个月和6个月龈乳头高度及龈乳头充盈指数。结果:龈乳头高度两组组内在术后即刻、术后2周、术后3个月各时间点比较有显著性差异(P<0.05),术后6个月与术后3个月比较无显著性差异;两组组间在同时间段内比较无显著性差异。龈乳头充盈指数两组无论是组内比较还是组间比较结果与龈乳头高度结果基本一致,但B组龈乳头充盈指数在术后2周与术后即刻比较除外。术后6个月A、B组仍各有6例牙间乳头未完全达接触点,牙间乳头充满邻间隙达接触点例数总占比为79.66%。结论:超薄瓷贴面关闭牙间隙,预留合适龈乳头间隙,可诱导牙龈乳头形成;前牙间隙大小在一定范围内不会影响牙龈乳头形成。