Parihar Anuj Singh, Nandanan Nimisha, Kurien Vino Tito V, Bandgar Subhash, Patri Gaurav, Laddha Rashmi, Kumar Santosh
Department of Periodontology, People's Dental Academy, Bhopal, Madhya Pradesh, India.
BDS, MDS in Periodontics and Implantology, PhD Scholar, Periodontist, Shri Vinobha Bhave Civil Hospital, Silvassa, Dadra and Nagar Haveli.
J Pharm Bioallied Sci. 2025 May;17(Suppl 1):S555-S557. doi: 10.4103/jpbs.jpbs_10_25. Epub 2025 May 10.
The periodontal biotype is a crucial factor influencing the esthetic outcome of implant-supported restorations. This prospective study evaluated the long-term impact of periodontal biotype on the esthetic stability of single-tooth implant-supported restorations in the anterior maxilla over a 5-year period, with a specific focus on the influence of platform-switching and immediate provisionalization.
Patients with a single missing tooth between the maxillary canines requiring implant placement were included. Periodontal biotype was assessed at baseline using the established criteria of probing depth ≤3 mm and gingival thickness ≥2 mm for thick biotype. All patients received Straumann Bone Level implants with a platform-switched design. Immediate provisionalization was performed following implant placement. Esthetic outcomes were evaluated annually for 5 years using the Pink Esthetic Score (PES) and White Esthetic Score (WES). Changes in soft tissue parameters, including gingival recession, papilla height, and mucosal level changes, were also recorded.
A total of 86 patients (45 thick biotype, 41 thin biotype) were included. At 5 years, both biotypes demonstrated remarkably stable esthetic outcomes with consistently high PES and WES scores. However, the thin biotype exhibited significantly greater mean gingival recession (1.2 mm vs. 0.5 mm, < 0.05) and a higher incidence of mucosal level changes (17% vs. 4%, < 0.05) compared to the thick biotype. Papilla height remained stable in both groups.
While both thick and thin biotypes demonstrated acceptable esthetic outcomes at 5 years with platform-switched implants and immediate provisionalization, thin biotype was associated with increased susceptibility to gingival recession and mucosal level changes. These findings underscore the crucial role of meticulous soft tissue management and individualized treatment planning in patients with thin biotypes. They are key to achieving optimal long-term esthetic results in implant dentistry and highlight the significance of your role as a dental professional.
牙周生物型是影响种植体支持修复体美学效果的关键因素。本前瞻性研究评估了牙周生物型对上颌前牙区单颗牙种植体支持修复体5年美学稳定性的长期影响，特别关注平台转换和即刻临时修复的影响。
纳入上颌尖牙之间单颗牙缺失需要种植的患者。在基线时，根据既定标准评估牙周生物型，厚生物型的探诊深度≤3 mm且牙龈厚度≥2 mm。所有患者均接受具有平台转换设计的Straumann骨水平种植体。种植体植入后进行即刻临时修复。使用粉色美学评分（PES）和白色美学评分（WES）对美学效果进行每年一次、为期5年的评估。还记录了软组织参数的变化，包括牙龈退缩、龈乳头高度和黏膜水平变化。
共纳入86例患者（厚生物型45例，薄生物型41例）。5年时，两种生物型均表现出显著稳定的美学效果，PES和WES评分始终较高。然而，与厚生物型相比，薄生物型的平均牙龈退缩明显更大（1.2 mm对0.5 mm，<0.05），黏膜水平变化的发生率更高（17%对4%，<0.05）。两组的龈乳头高度均保持稳定。
虽然厚生物型和薄生物型在5年时使用平台转换种植体和即刻临时修复均表现出可接受的美学效果，但薄生物型更容易出现牙龈退缩和黏膜水平变化。这些发现强调了在薄生物型患者中进行细致的软组织管理和个性化治疗计划的关键作用。它们是在种植牙科中实现最佳长期美学效果的关键，并突出了你作为牙科专业人员角色的重要性。
