Zhan Lu, Yang Yang, Zhao Xiwen, Wang Chenbing, Man Yi, Qu Yili
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
Department of Dentistry, The First People's Hospital of Foshan, 528200, Foshan, China.
BMC Oral Health. 2025 Jul 2;25(1):1064. doi: 10.1186/s12903-025-06310-w.
Adequate keratinized mucosa around implants is crucial for maintaining peri-implant hard and soft tissue health. Concentrated growth factor (CGF), a novel platelet concentrate, has been widely applied to promote tissue regeneration and wound healing, which could also be effective in peri-implant keratinized mucosa augmentation. This prospective case series aimed to present the clinical outcomes of apically repositioned flap (ARF) combined with CGF and to provide histological evidence.
Patients with insufficient keratinized mucosa (< 2 mm) were included. ARF combined with CGF was performed to augment the keratinized mucosa. Changes in the keratinized mucosa width (KMW) and vestibular depth (VD) from surgery to 12 months were documented. The secondary endpoints included the mucosal thickness (MT), marginal bone loss (MBL), modified plaque index (mPI), bleeding on probing (BOP), and probing depth (PD). Additionally, two biopsy samples were collected to analyze their tissue morphology and keratin expression.
Thirty patients with a mean age of 46.0 ± 13.4 years and a total of 48 implant sites were recruited for the study. The KMW increased significantly from 1.44 ± 0.54 mm to 5.04 ± 1.64 mm at 2 weeks and stabilized at 2.48 ± 0.80 mm over 1 year (p < 0.001). The VD improved from 4.46 ± 2.38 mm to 5.32 ± 1.93 mm at 1-year post-ARF (p < 0.001). The MT increased from 1.48 ± 0.48 mm to 2.45 ± 0.70 mm (p < 0.001). After 1 year, the mPI and BOP were 0.47 ± 0.93 and 0.17 ± 0.39, respectively. The PD and MBL were 2.39 ± 0.59 mm and 0.36 ± 0.24 mm, respectively. Histological evaluation confirmed a typical keratinized mucosal structure with appropriate expression of keratin 5 and 10.
Within the limitations of this case series, our findings suggested that the use of ARF combined with CGF could be a reliable approach for keratinized mucosal augmentation and vestibular deepening. KMW achieved the clinically ideal value of more than 2 mm one year after surgery. Histological analysis revealed the formation of keratinized mucosa around the implants.
种植体周围充足的角化黏膜对于维持种植体周围软硬组织健康至关重要。浓缩生长因子（CGF）是一种新型血小板浓缩物，已被广泛应用于促进组织再生和伤口愈合，其在种植体周围角化黏膜增量方面也可能有效。本前瞻性病例系列旨在展示根尖向复位瓣（ARF）联合CGF的临床效果并提供组织学证据。
纳入角化黏膜不足（<2mm）的患者。采用ARF联合CGF来增加角化黏膜。记录从手术至12个月时角化黏膜宽度（KMW）和前庭深度（VD）的变化。次要终点包括黏膜厚度（MT）、边缘骨吸收（MBL）、改良菌斑指数（mPI）、探诊出血（BOP）和探诊深度（PD）。此外，采集两份活检样本以分析其组织形态和角蛋白表达。
本研究共纳入30例患者，平均年龄46.0±13.4岁，共48个种植位点。KMW在2周时从1.44±0.54mm显著增加至5.04±1.64mm，并在1年中稳定在2.48±0.80mm（p<0.001）。ARF术后1年，VD从4.46±2.38mm改善至5.32±1.93mm（p<0.001）。MT从1.48±0.48mm增加至2.45±0.70mm（p<0.
