Greenstein Gary, Cavallaro John
Department of Periodontology, School of Dental Medicine, Columbia University, New York, New York, USA.
Compend Contin Educ Dent. 2011 Oct;32(8):24-31; quiz 32, 34.
Whether or not keratinized tissue is needed around dental implants to maintain peri-implant health is a controversial subject. To clarify this issue a search was conducted for clinical trials that appraised the significance ofkeratinized gingiva (KG) around teeth and dental implants. A critical assessment of the data revealed that the literature is replete with studies that contradict one another with respect to the need for KG as it relates to survivability of implants, gingival response to plaque, inflammation, probing depths, recession, and loss of bone. When groups of patients with and without KG were compared with respect to various clinical parameters, a statistically significant better result in the presence of KG could be interpreted to indicate that having KG is advantageous. However, quantitative differences between groups with and without KG were usually very small. Overall, the data was interpreted to indicate that some patients may need augmentation of keratinized tissue to maintain peri-implant health. Ultimately, the decision to augment KG is a judgment call that needs to be made by the treating clinician, because there are not enough data to facilitate development of definitive guidelines relevant to this subject. Apparently, the need for KG is patient specific, and at present there is no method to reliably predict who would benefit from tissue augmentation.
种植牙周围是否需要角化组织来维持种植体周围健康是一个有争议的话题。为了阐明这个问题，我们检索了评估牙齿和种植牙周围角化龈（KG）意义的临床试验。对数据的批判性评估显示，文献中充斥着关于KG与种植体存活率、牙龈对菌斑的反应、炎症、探诊深度、退缩和骨丧失相关需求的相互矛盾的研究。当比较有和没有KG的患者组在各种临床参数方面的情况时，在有KG的情况下统计学上显著更好的结果可以解释为表明有KG是有利的。然而，有和没有KG的组之间的定量差异通常非常小。总体而言，数据被解释为表明一些患者可能需要增加角化组织来维持种植体周围健康。最终，是否增加KG的决定是治疗临床医生需要做出的判断，因为没有足够的数据来制定与该主题相关的明确指南。显然，对KG的需求是因人而异的，目前没有方法可靠地预测谁将从组织增加中受益。
