Mailoa James, Miron Richard J, Wang Hom-Lay
Resident, Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan.
ITI Scholar, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan; Research Fellow, Department of Periodontology, Nova Southeastern University, Fort Lauderdale, Florida.
Compend Contin Educ Dent. 2017 Jul;38(7):436-443; quiz 444.
Achieving a long-term esthetic implant restoration in the maxillary anterior area is sometimes unpredictable. This article reviews several risk indicators of implant mucosal recession and loss of interproximal papillae, and how to prevent these risks. Results obtained from the literature suggest that the following factors are strongly related to implant soft-tissue complications: buccally positioned implant placement, a thin gingival biotype, lack of an adequate amount of keratinized mucosa, implant placement after ridge augmentation procedures, an increased distance of tooth bone peak to the contact point, and an inadequate horizontal implant-tooth distance. Factors that have been shown to favor longterm stability and improve implant esthetic outcomes include implant placement in an ideal 3-dimensional position, use of platform-switching implant/abutment designs, and performing soft-tissue grafting. Careful assessment of the above factors and adoption of suggested guidelines are critical to executing successful implant placement with favorable esthetic outcomes while minimizing soft-tissue complications.
在上颌前部区域实现长期的美观种植修复有时是不可预测的。本文综述了种植体黏膜退缩和邻间隙乳头丧失的几个风险指标，以及如何预防这些风险。从文献中获得的结果表明，以下因素与种植体软组织并发症密切相关：种植体颊侧植入、薄龈生物型、角化黏膜量不足、牙槽嵴增高术后植入种植体、牙骨嵴顶到接触点的距离增加以及种植体与牙齿的水平距离不足。已证明有利于长期稳定性并改善种植体美学效果的因素包括将种植体植入理想的三维位置、使用平台转换种植体/基台设计以及进行软组织移植。仔细评估上述因素并采用建议的指导方针对于成功进行种植体植入并获得良好美学效果同时将软组织并发症降至最低至关重要。
