Department of Oral Surgery and Implantology, Johann Wolfgang Goethe-University, Carolinum, Frankfurtam am Main, Germany.
Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurtam am Main, Germany.
Clin Oral Implants Res. 2022 Jun;33 Suppl 23:8-31. doi: 10.1111/clr.13766.
To evaluate the influence of the width of keratinized tissue (KT) on the prevalence of peri-implant diseases, and soft- and hard-tissue stability.
Clinical studies reporting on the prevalence of peri-implant diseases (primary outcome), plaque index (PI), modified plaque index (mPI), bleeding index (mBI), bleeding on probing (BOP), probing pocket depths (PD), mucosal recession (MR), and marginal bone loss (MBL) and/or patient-reported outcomes (PROMs; secondary outcomes) were searched. The weighted mean differences (WMD) were estimated for the assessed clinical and radiographic parameters by employing a random-effect model that considered different KT widths (i.e., <2 and ≥2 mm).
Twenty-two articles describing 21 studies (15 cross-sectional, five longitudinal comparative studies, and one case series with pre-post design) with an overall high to low risk of bias were included. Peri-implant mucositis and peri-implantitis affected 20.8% to 42% and at 10.5% to 44% of the implants with reduced or absent KT (i.e., <2 mm or 0 mm). The corresponding values at the implant sites with KT width of ≥2 mm or >0 mm were 20.5% to 53% and 5.1% to 8%, respectively. Significant differences between implants with KT < 2 mm and those with KT ≥ 2 mm were revealed for WMD for BOP, mPI, PI, MBL, and MR all favoring implants with KT ≥ 2 mm.
Reduced KT width is associated with an increased prevalence of peri-implantitis, plaque accumulation, soft-tissue inflammation, mucosal recession, marginal bone loss, and greater patient discomfort.
评估角化组织（KT）宽度对种植体周围疾病的患病率、软组织和硬组织稳定性的影响。
检索了报道种植体周围疾病患病率（主要结局）、菌斑指数（PI）、改良菌斑指数（mPI）、出血指数（mBI）、探诊出血（BOP）、探诊深度（PD）、黏膜退缩（MR）和边缘骨丧失（MBL）和/或患者报告结局（PROM；次要结局）的临床研究。采用随机效应模型，根据不同的 KT 宽度（即<2mm 和≥2mm），对评估的临床和影像学参数进行加权均数差（WMD）估计。
纳入了 22 篇描述了 21 项研究（15 项横断面研究、5 项纵向比较研究和 1 项具有前后设计的病例系列研究）的文章，这些研究的整体偏倚风险较高至较低。种植体周围黏膜炎和种植体周围炎影响了 20.8%至 42%和 10.5%至 44%的 KT 减少或缺失（即<2mm 或 0mm）的种植体。在 KT 宽度≥2mm 或>0mm 的种植体部位，相应的数值分别为 20.5%至 53%和 5.1%至 8%。在 BOP、mPI、PI、MBL 和 MR 的 WMD 方面，KT<2mm 的种植体与 KT≥2mm 的种植体之间存在显著差异，所有这些都有利于 KT≥2mm 的种植体。
减少 KT 宽度与种植体周围炎、菌斑堆积、软组织炎症、黏膜退缩、边缘骨丧失和患者不适的发生率增加有关。
