Jha Anju, Patil Rohit, Ashraf Samra, Perween Naila, Mulani Shahinwaz, Dodamani Girija, Gupta Seema
Department of Pediatric and Preventive Dentistry, Patna Dental College and Hospital, Patna, IND.
Department of Prosthodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial Dental College, Dhule, IND.
Cureus. 2025 May 4;17(5):e83477. doi: 10.7759/cureus.83477. eCollection 2025 May.
Introduction Accurate selection of gingival formers is critical for achieving optimal peri-implant soft tissue health and esthetics. Crestal mucosal thickness may play a significant role in the success of gingival former selection, particularly in single-tooth implant prosthodontics. The present study aimed to evaluate the impact of crestal mucosal thickness on the accuracy of gingival former selection using retrospective clinical data and cone-beam computed tomography (CBCT) analysis. Materials and methods This retrospective, cross-sectional, observational study was conducted in the Department of Prosthodontics after obtaining ethical approval. Patient records of 150 implant sites from August 2021 to December 2024 were reviewed. The inclusion criteria were adults (18-65 years) with single-tooth implants, adequate periodontal health, and complete clinical documentation, including CBCT scans. Patients with systemic conditions, tobacco use, or incomplete medical records were excluded. CBCT images were used to measure crestal mucosal thickness. The gingival former type, diameter, and clinical outcomes were documented. Accuracy of gingival former selection was defined as the absence of inflammation, ulceration, or recession, along with a good emergence profile at the final prosthetic placement. Statistical analyses included chi-square tests, independent t-tests, and multivariate logistic regression. Results Of the 150 implant sites, 108 (72%) had accurate gingival former selection, while 42 (28%) showed complications. No significant associations were found for sex (p = 0.894), jaw (p = 0.860), or site (p = 0.138). However, mucosal thickness significantly influenced selection accuracy (p = 0.001), with inaccurate outcomes more common in sites with <2 mm thickness. Accurate selections had significantly thicker mucosa (mean = 2.43 ± 0.3 mm) and smaller gingival formers (mean diameter = 4.45 ± 0.74 mm). Logistic regression revealed that thinner mucosa (odds ratio = 13.92) and larger former diameter (odds ratio = 4.15) were independent predictors of inaccurate selection. Conclusion Crestal mucosal thickness is a critical determinant for the accurate selection of gingival formers. Thin soft tissue biotypes and inaccurate formers significantly increase the risk of peri-implant soft tissue complications. Preoperative CBCT assessment and a tissue-informed approach are essential for optimizing outcomes in implant prosthodontics.
准确选择牙龈成形器对于实现最佳种植体周围软组织健康和美观至关重要。牙槽嵴黏膜厚度可能在牙龈成形器选择的成功中发挥重要作用，尤其是在单颗牙种植修复中。本研究旨在利用回顾性临床数据和锥形束计算机断层扫描（CBCT）分析评估牙槽嵴黏膜厚度对牙龈成形器选择准确性的影响。
本回顾性、横断面观察性研究在获得伦理批准后于口腔修复科进行。回顾了2021年8月至2024年12月期间150个种植位点的患者记录。纳入标准为年龄在18 - 65岁之间的单颗牙种植成年患者，牙周健康状况良好，并有完整的临床记录，包括CBCT扫描。排除有全身疾病、吸烟或病历不完整的患者。使用CBCT图像测量牙槽嵴黏膜厚度。记录牙龈成形器的类型、直径和临床结果。牙龈成形器选择的准确性定义为在最终修复体植入时无炎症、溃疡或退缩，且龈缘形态良好。统计分析包括卡方检验、独立样本t检验和多因素逻辑回归。
在150个种植位点中，108个（72%）牙龈成形器选择准确，而42个（28%）出现并发症。在性别（p = 0.894）、颌骨（p = 0.860）或种植位点（p = 0.138）方面未发现显著关联。然而，黏膜厚度显著影响选择准确性（p = 0.001），厚度小于2mm的位点出现不准确结果更为常见。准确选择的黏膜明显更厚（平均值 = 2.43 ± 0.3mm），牙龈成形器更小（平均直径 = 4.45 ± 0.74mm）。逻辑回归显示，较薄的黏膜（优势比 = 13.92）和较大的成形器直径（优势比 = 4.15）是选择不准确的独立预测因素。
牙槽嵴黏膜厚度是准确选择牙龈成形器的关键决定因素。薄软组织生物型和不合适的成形器会显著增加种植体周围软组织并发症的风险。术前CBCT评估和基于组织情况的方法对于优化种植修复的结果至关重要。
