Sohn Joo-Yeon, Park Jung-Chul, Cho Kyoo-Sung, Kim Chang-Sung
Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
Department of Periodontology, Research Institute for Periodontal Regeneration, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea.
J Periodontal Implant Sci. 2014 Apr;44(2):94-9. doi: 10.5051/jpis.2014.44.2.94. Epub 2014 Apr 24.
Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the long-term outcome of this grafted gingiva.
A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap.
At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue.
Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.
多种外科技术旨在在牙种植体周围获得足够的角化组织；然而，这些技术通常在种植体植入前或潜入式种植体暴露时进行。本病例报告的目的是描述在一名缺乏角化组织的患者中同时植入间置游离龈瓣（iFGG）和非潜入式种植体，并评估该移植龈组织的长期效果。
从腭部获取一个楔形游离龈瓣（FGG），包括上皮 - 结缔组织（E - C）部分和仅结缔组织（CT）部分。将CT部分插入颊侧瓣下方，E - C部分紧密固定在种植体周围并与舌侧瓣固定。
在8年的随访中，牙龈移植瓣保持牢固附着且维护良好，在口腔卫生操作期间无明显收缩或不适报告。在非潜入式种植体植入时使用iFGG可减少所需的手术步骤数量和患者不适，同时提供足够的颊侧角化组织。
因此，对于角化组织量极少的病例，该技术可被视为增加角化组织的一种替代方法。
