Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.
Department of Periodontology, Kyung Hee University, College of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul, Republic of Korea.
J Clin Periodontol. 2024 May;51(5):665-677. doi: 10.1111/jcpe.13949. Epub 2024 Jan 24.
To histomorphometrically assess three treatment modalities for gaining keratinized tissue (KT) at teeth and at dental implants.
In five dogs, the distal roots of the mandibular second, third and fourth premolars were extracted. Dental implants were placed at the distal root areas 2 months later. After another 2 months, KT augmentation was performed at both distal (implants) and at mesial root (teeth) areas in the presence (wKT groups) or absence (w/oKT groups) of a KT band at the mucosal/gingival level. Three treatment modalities were applied randomly: apically positioned flap only (APF), free gingival grafts (FGGs) and xenogeneic collagen matrices (XCMs). A combination of the above produced six groups. Two months later, tissue sections were harvested and analysed histomorphometrically.
The median KT height and length were greatest at implants with FGG in both wKT (3.7 and 5.1 mm, respectively) and w/oKT groups (3.7 and 4.6 mm), and at teeth with FGG in wKT groups (3.7 and 6.1 mm) and with APF in the w/oKT groups (3.9 and 4.4 mm). The XCM and APF produced more favourable results at teeth than at implants.
FGG was advantageous in gaining KT, especially at implants.
通过组织形态计量学评估三种获得牙齿和种植体角化组织(KT)的治疗方法。
在 5 只狗中,下颌第二、第三和第四前磨牙的远中根被拔出。2 个月后,在远中根区域植入牙科种植体。2 个月后,在远中(种植体)和近中(牙齿)根区,在存在(wKT 组)或不存在(w/oKT 组)黏膜/牙龈水平的 KT 带的情况下,进行 KT 增强。随机应用三种治疗方法:根尖定位瓣(APF)、游离龈移植(FGG)和异种胶原基质(XCM)。上述方法的组合产生了 6 个组。2 个月后,采集组织切片并进行组织形态计量学分析。
在 wKT 组(分别为 3.7 和 5.1mm)和 w/oKT 组(分别为 3.7 和 4.6mm)中,FGG 应用于种植体时 KT 高度和长度中位数最大;在 wKT 组中 FGG 应用于牙齿时 KT 高度和长度中位数最大(3.7 和 6.1mm),在 w/oKT 组中 APF 应用于牙齿时 KT 高度和长度中位数最大(3.9 和 4.4mm)。XCM 和 APF 在牙齿上的效果优于在种植体上。
FGG 有利于获得 KT,尤其是在种植体上。