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基于风险评估的牙种植体周围角化黏膜增量手术的有效性:一项5年回顾性队列研究。

Effectiveness of keratinized mucosa augmentation procedures around dental implants based on risk assessment: A 5-year retrospective cohort study.

作者信息

Wang Jing, Xie Chao, Wei Hongbo, Yu Zhuo, Li Dehua

机构信息

State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China.

出版信息

J Prosthodont Res. 2025 Jan 10;69(1):82-90. doi: 10.2186/jpr.JPR_D_23_00185. Epub 2024 Sep 3.

Abstract

PURPOSE

To compare the effectiveness of keratinized mucosa (KM) augmentation with different techniques for the treatment of dental implants based on risk assessment.

METHODS

Thirty-nine patients who underwent KM augmentation at implant sites in the posterior mandible were included. Three techniques were used based on anatomy-guided risk assessment: an apically positioned flap (APF) alone, an APF plus a free gingival graft (APF plus FGG), and an APF plus a collagen matrix (APF plus CM). Clinically effective KM augmentation was defined as remaining KM ≥ 2 mm after the intervention. The effective rate, implant/prosthesis survival rates, and bone/soft tissue parameters were analyzed. The correlation between local anatomical characteristics and different techniques was also determined. The associations between the effectiveness of KM augmentation and related factors were analyzed using a linear model.

RESULTS

Overall, 74 sites received KM augmentation in the posterior mandible, for an effective rate of 94.6% at the 1-year follow-up and 93.2% at the 5-year follow-up. The KM width in the APF plus FGG group (3.85 ± 1.22 mm) was greater than that in the APF alone (3.05 ± 0.90 mm) (P = 0.016) and APF plus CM (3.21 ± 1.17 mm) groups (P = 0.038) at 5 years post-surgery. There was no significant difference in the effective/ineffective outcomes at the 1-year or 5-year follow-up among the three groups.

CONCLUSIONS

Comparable effective outcomes were achieved with three KM augmentation techniques following the decision-making criterion based on risk assessment.

摘要

目的

基于风险评估,比较不同技术进行角化黏膜(KM)增量术治疗牙种植体的有效性。

方法

纳入39例在下颌后牙种植部位接受KM增量术的患者。根据解剖引导的风险评估使用了三种技术:单纯根向复位瓣(APF)、APF联合游离龈移植术(APF+FGG)和APF联合胶原基质(APF+CM)。临床有效的KM增量术定义为干预后剩余KM≥2mm。分析有效率、种植体/修复体生存率以及骨/软组织参数。还确定了局部解剖特征与不同技术之间的相关性。使用线性模型分析KM增量术有效性与相关因素之间的关联。

结果

总体而言,74个部位在下颌后牙接受了KM增量术,1年随访时有效率为94.6%,5年随访时为93.2%。术后5年,APF+FGG组的KM宽度(3.85±1.22mm)大于单纯APF组(3.05±0.90mm)(P=0.016)和APF+CM组(3.21±1.17mm)(P=0.038)。三组在1年或5年随访时的有效/无效结果无显著差异。

结论

基于风险评估的决策标准,三种KM增量术取得了可比的有效结果。

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