Tabanella Giorgio
Oral Reconstruction and Education Center Rome, Rome, Italy.
Clin Adv Periodontics. 2022 Mar;12(1):5-11. doi: 10.1002/cap.10128. Epub 2020 Nov 5.
A special interest has been raised regarding the role of the peri-implant mucosa as a critical factor for long-term maintenance of the artificial fixtures as well as the final esthetic outcome that may significantly affect patient satisfaction. It is then imperative to develop minimally invasive and easy-to-apply plastic surgical methods to increase the volume of the peri-implant mucosa.
The limited scientific evidence regarding possible techniques to treat esthetic soft tissue defects around endosseous implants is encouraging a preventive soft tissue augmentation of mucosa deficiencies and thin phenotypes. Several techniques have been proposed to augment the volume of the mucosa to achieve the so-called pink esthetics. Among these the buccal pedicle flap seems to be less invasive in terms of morbidity since it does not necessitate any soft tissue harvesting. Its low morbidity allows it to treat patients without the need of postoperative medications since it reduces pain, the risk of infections, alteration of the sensitivity of the donor site and significantly reduces the period of healing which is generally longer when associated with connective tissue grafts. A modified surgical approach is based on the combination of the buccal pedicle flap with a stable collagen matrix to boost a biomimetic peri-implant mucosa and generate a convex pink interface with the final restoration.
The proposed modified buccal pedicle flap seems to be promising in terms of decreased morbidity and maintenance of the blood supply, and conducive to an increased patient acceptance rate.
种植体周围黏膜作为人工种植体长期维持以及最终美学效果的关键因素,其作用引发了特别关注,而最终美学效果可能会显著影响患者满意度。因此,开发微创且易于应用的整形手术方法以增加种植体周围黏膜的体积势在必行。
关于治疗骨内种植体周围美学软组织缺损的可能技术的科学证据有限,这促使人们对黏膜缺损和薄型表型进行预防性软组织增量。已经提出了几种技术来增加黏膜体积以实现所谓的粉色美学。其中,颊蒂瓣在发病率方面似乎侵入性较小,因为它不需要采集任何软组织。其低发病率使得在治疗患者时无需术后用药,因为它减轻了疼痛、感染风险、供区敏感性改变,并显著缩短了愈合时间,而与结缔组织移植相关时愈合时间通常更长。一种改良的手术方法是将颊蒂瓣与稳定的胶原基质相结合,以促进仿生种植体周围黏膜,并与最终修复体形成凸起的粉色界面。
所提出的改良颊蒂瓣在降低发病率和维持血供方面似乎很有前景,并且有利于提高患者接受率。