Abu Hussien Hiba, Machtei Eli E, Khutaba Alaa, Gabay Eran, Zigdon Giladi Hadar
Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.
Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel.
Clin Implant Dent Relat Res. 2023 Apr;25(2):215-223. doi: 10.1111/cid.13171. Epub 2022 Dec 20.
Previous studies focused on the influence of buccal mucosa thickness on peri-implant bone loss and inflammation, with inconclusive results. We observed substantially thicker palatal mucosal tissues at peri-implantitis sites. Therefore, we hypothesize that thick palatal peri-implant mucosa may be associated with deeper pockets and disease severity.
To compare the thickness of the palatal tissue between natural teeth and implants in periodontal health and disease.
Adult, non-smoker, healthy patients who visited our department for periodontal examination or treatment with restored implants in the posterior maxilla were recruited. Probing depth (PD), plaque index (PI), gingival index (GI) and radiographic measurements were recorded around implant and the contralateral tooth. Palatal tissue thickness was measured using a 30G needle that was inserted perpendicular into the mucosa at the bottom of the periodontal/peri-implant pocket and 3 mm coronally. Differences in the palatal tissue thickness between teeth and implants (in the same patient) was performed using t-test; as well as between peri-implantitis and non-peri-implantitis sites (among patients).
Sixty patients were included. Thirty-four implants were diagnosed with peri-implantitis and 26 healthy/mucositis implants with corresponding 24 healthy/gingivitis teeth and 36 teeth with attachment loss. Mean PD was higher around implants (4.47 ± 1.57 mm) than teeth (3.61 ± 1.23 mm, p = 0.001). The thickness of implants' palatal mucosa was higher than in teeth, at the base of the pocket and 3 mm coronally (4.58 ± 1.38 mm vs. 3.01 ± 1.11, p = 0.000; 3.58 ± 2.15 vs. 1.89 ± 1.11, p = 0.000, respectively). Mean palatal tissue thickness was 4.32 ± 2.35 mm for the peri-implantitis group while only 2.61 ± 1.39 in healthy implants, 3 mm coronal to the base of the pocket (p = 0.001). Palatal thickness at peri-implantitis sites was higher (4.32 ± 2.35) compared to periodontitis sites (2.23 ± 0.93), p = 0.000. Implant sites with palatal mucosa >4 mm (n = 32) had deeper mean pockets (5.58 ± 1.98) compared with thinner (≤4 mm) sites (n = 28) (4.48 ± 1.18, p = 0.018).
Thicker palatal tissue around implants is associated with deeper palatal pockets. Thick palatal tissue was found around implants diagnosed with peri-implantitis.
以往研究聚焦于颊黏膜厚度对种植体周围骨吸收和炎症的影响，结果尚无定论。我们观察到种植体周炎部位的腭黏膜组织明显更厚。因此，我们推测厚的种植体周围腭黏膜可能与更深的牙周袋及疾病严重程度有关。
比较牙周健康和患病状态下天然牙与种植体周围腭组织的厚度。
招募成年、不吸烟、因上颌后牙种植体修复前来我科进行牙周检查或治疗的健康患者。记录种植体及对侧牙齿周围的探诊深度（PD）、菌斑指数（PI）、牙龈指数（GI）及影像学测量数据。使用30G针头垂直插入牙周/种植体周围袋底部及冠方3mm处的黏膜来测量腭组织厚度。采用t检验比较同一患者牙齿与种植体之间以及患者中种植体周炎与非种植体周炎部位之间腭组织厚度的差异。
纳入60例患者。34枚种植体被诊断为种植体周炎，26枚健康/患黏膜炎的种植体，对应24颗健康/患牙龈炎的牙齿及36颗有附着丧失的牙齿。种植体周围的平均PD（4.47±1.57mm）高于牙齿（3.61±1.23mm，p = 0.001）。种植体腭黏膜在袋底部及冠方3mm处的厚度高于牙齿（分别为4.58±1.38mm对3.01±1.11mm，p = 0.000；3.58±2.15mm对1.89±1.11mm，p = 0.000）。种植体周炎组腭组织平均厚度在袋底部冠方3mm处为4.32±2.35mm，而健康种植体仅为2.61±1.39mm（p = 0.001）。种植体周炎部位的腭厚度（4.32±2.35）高于牙周炎部位（2.23±0.93），p = 0.000。腭黏膜>4mm的种植体部位（n = 32）平均牙周袋更深（5.58±1.98），相比之下较薄（≤4mm）部位（n = 28）为（4.48±1.18）（p = 0.018）。
种植体周围较厚的腭组织与更深的腭部牙周袋有关。在被诊断为种植体周炎的种植体周围发现有厚的腭组织。
