Hsu Yung-Ting, Shieh Chia-Huang, Wang Horn-Lay
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.
J Int Acad Periodontol. 2012 Jul;14(3):76-82.
With advances in dental technology, the placement of immediate implants has progressively gained popularity. However, a common complication that surfaced was mid-facial mucosal recession, which impaired esthetic outcomes. The use of soft tissue grafts has thus been introduced to manage and prevent this undesirable result. To date, no guidelines have been put forward for clinicians to identify the indications for a soft tissue graft during immediate implant placement. Therefore, this manuscript aimed to propose a decision-making model to prevent mid-facial mucosal recession following immediate implant placement.
An electronic search of the PubMed database for literature published in English on the occurrence and management of soft tissue alterations following immediate implant placement was performed.
Several factors, including implant position, buccal plate thickness, tissue thickness and width of keratinized mucosa, were found to influence the need for soft tissue grafting during immediate implant placement. For sockets with at least 2 mm of buccal plate thickness, a soft tissue graft was recommended for immediate implants placed at the incisal position. For sockets with less than 2 mm of buccal plate thickness, immediate implant placement in combination with bone or soft tissue augmentation was necessary. This was especially critical in scenarios with thin tissue biotypes or inadequate width of keratinized mucosa.
Soft tissue grafts can maintain soft tissue stability following immediate implant placement.
随着牙科技术的进步，即刻种植的应用逐渐普及。然而，出现的一个常见并发症是面部中段黏膜退缩，这影响了美学效果。因此，软组织移植已被用于处理和预防这种不良后果。迄今为止，尚未为临床医生提出在即刻种植时识别软组织移植适应证的指南。因此，本手稿旨在提出一个决策模型，以预防即刻种植后面部中段黏膜退缩。
对PubMed数据库进行电子检索，查找以英文发表的关于即刻种植后软组织改变的发生及处理的文献。
发现几个因素，包括种植体位置、颊侧骨板厚度、组织厚度和角化黏膜宽度，会影响即刻种植时软组织移植的需求。对于颊侧骨板厚度至少为2 mm的牙槽窝，建议对位于切牙位置的即刻种植体进行软组织移植。对于颊侧骨板厚度小于2 mm的牙槽窝，需要将即刻种植与骨或软组织增量相结合。在组织生物型薄或角化黏膜宽度不足的情况下，这一点尤为关键。
软组织移植可在即刻种植后维持软组织稳定性。
