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牙齿及牙种植体处异位黏膜转位的临床及组织学评估

Clinical and histologic evaluation of heterotopic mucosa transpositioning at teeth and dental implants.

作者信息

Imber Jean-Claude, Roccuzzo Andrea, Stähli Alexandra, Bosshardt Dieter D, Muñoz Fernando, Ramseier Christoph A, Lang Niklaus P, Sculean Anton

机构信息

Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.

Department of Veterinary Clinical Sciences, University of Santiago de Compostela, Lugo, Spain.

出版信息

Clin Oral Implants Res. 2023 Dec;34(12):1395-1405. doi: 10.1111/clr.14184. Epub 2023 Sep 30.

Abstract

AIM

To investigate the healing after heterotopic mucosa transpositioning at dental implants and teeth.

MATERIALS AND METHODS

One hemimandible per dog (n = 4) was allocated to receive 3 implants (test), whereby 3 premolars on the contralateral side served as controls. After osseointegration, a Z-plasty was performed on the buccal aspect of the test and control sites to heterotopically move the zone of keratinized tissue (KT) into a region with non-keratinized tissue (nKT) and vice versa. Clinical measurements were performed before (T0) and at 12 weeks following heterotopic transposition (T1). Thereafter, specimens were processed for histological analysis.

RESULTS

Clinical measurements revealed that at T1, a band of KT was reestablished at teeth (mean: 2.944 ± 1.866 mm), whereas at implants, the transpositioned nKT resulted in a mucosa without any signs of keratinization (mean: 0 mm; p < .0001). At implant sites, the probing attachment level loss was more pronounced compared to tooth sites (-1.667 ± 1.195 mm and -1.028 ± 0.878 mm, respectively; p = .0076). Histologically, the transpositioned nKT, was accompanied by the formation of KT at the tooth but not at implant sites. The supracrestal soft tissues were statistically significantly higher at tooth compared to implant sites (2.978 ± 0.483 mm and 2.497 ± 0.455 mm, p = .0083). The transpositioned KT remained mostly unaltered in its morphological characteristics.

CONCLUSIONS

The findings of this study indicate that: (a) transpositioned KT may retain its morphological characteristics; and (b) transpositioned nKM was accompanied by the formation of KT at the tooth but not at implant sites.

摘要

目的

研究牙种植体和牙齿处异位黏膜转位后的愈合情况。

材料与方法

每只犬(n = 4)的一侧半下颌骨接受3枚种植体(试验组),对侧的3颗前磨牙作为对照组。骨结合完成后,在试验组和对照组部位的颊侧进行Z成形术,将角化组织(KT)区域异位移动到非角化组织(nKT)区域,反之亦然。在异位转位前(T0)和转位后12周(T1)进行临床测量。此后,对标本进行组织学分析。

结果

临床测量显示,在T1时,牙齿处重新建立了一条KT带(平均:2.944±1.866 mm),而在种植体处,转位的nKT导致黏膜无任何角化迹象(平均:0 mm;p <.0001)。与牙齿部位相比,种植体部位的探诊附着水平丧失更明显(分别为-1.667±1.195 mm和-1.028±0.878 mm;p = 0.0076)。组织学上,转位的nKT在牙齿处伴有KT形成,但在种植体部位没有。牙齿部位的龈上软组织在统计学上显著高于种植体部位(2.978±0.483 mm和2.497±0.455 mm,p = 0.0083)。转位的KT在形态特征上大多保持不变。

结论

本研究结果表明:(a)转位的KT可能保留其形态特征;(b)转位后的nKM在牙齿处伴有KT形成,但在种植体部位没有。

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