Dental İmplant Uygulamalarında Yumuşak Doku Cerrahi Gereksiniminin Değerlendirilmesi

Year 2021, Volume: 5 Issue: 2, 113 - 118, 01.09.2021

Ebru Sağlam , Nesrin Saruhan

https://doi.org/10.34084/bshr.933138

Abstract

Amaç: Etkin plak kontrolü, mukozal çekilmenin önlenmesi, fonksiyonel ve protetik olarak implant çevresindeki dokunun adaptasyonunu sağlamak, hasta konforunu artırmak için implant çevresi keratinize mukozanın genişliği ve yumuşak doku kalınlığı önemlidir. Bu çalışmanın amacı dental implant cerrahisi sonrasında implant çevresi yumuşak doku cerrahisi gereksinimini değerlendirmektir. Yöntem: Dental implant uygulanan, periodontal ve sistemik sağlıklı, klinik ve radyolojik verileri bulunan 168 birey çalışmaya dahil edildi. 539 implantta ikinci aşama cerrahide yumuşak doku cerrahisi gereksinimi ve uygulanan cerrahi yöntem retrospektif olarak incelendi. Bulgular: İncelenen 539 implantın 31’ine ilave yumuşak doku cerrahisi gerekmiştir. Bunların 28 (%5,2)’i vestibüloplasti, 3 (%0,6)’ü serbest dişeti grefti (SDG) operasyonu olup, tüm ilave cerrahilerin alt çenede labial/bukkal bölgede yapıldığı tespit edilmiştir. Sonuç: İmplantların başarılı şekilde ağızda idame edilebilmesi ve hasta konforunun sağlanabilmesi için vakanın gereksinimine uygun cerrahi prosedürlerin kullanılması ve implant çevresi yumuşak doku yönetiminin yapılması klinik açıdan önem taşımaktadır.

Keywords

Dental implant, Serbest dişeti grefti, Keratinize dişeti, Mukozal kalınlık

Thanks

Yazarlar, King Faisal Üniversitesi Diş Hekimliği Fakültesi’nden Dr. Muhammad Adeel Ahmed’e ve arkadaşlarına verdikleri desteklerden teşekkür etmektedir.

References

• Mazzotti C, Stefanini M, Felice P, et al. Soft-tissue dehiscence coverage at peri-implant sites. Periodontol 2000 2018;77:256-272.
• Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol 2018;45 Suppl 20:S1-S8.
• Jung RE, Herzog M, Wolleb K, et al. A randomized controlled clinical trial comparing small buccal dehiscence defects around dental implants treated with guided bone regeneration or left for spontaneous healing. Clin Oral Implants Res 2017;28:348-354.
• Schwarz F, Sahm N, Becker J. Impact of the outcome of guided bone regeneration in dehiscence-type defects on the long-term stability of peri-implant health: clinical observations at 4 years. Clin Oral Implants Res 2012;23:191-196.
• Hammerle CHF, Tarnow D. The etiology of hard- and soft-tissue deficiencies at dental implants: A narrative review. J Clin Periodontol 2018;45 Suppl 20:S267-S277.
• Puisys A, Linkevicius T. The influence of mucosal tissue thickening on crestal bone stability around bone-level implants. A prospective controlled clinical trial. Clin Oral Implants Res 2015;26:123-129.
• Saglam E, Köseoğlu S. Peri-implant sert ve yumuşak doku eksiklikleri. Periodontal Hastalıkların Sınıflandırılması, 1. Baskı, cilt 7, Ertuğrul AS, Dikilitaş A (Ed), Ankara. Türkiye Klinikleri, 2021;s 63-70.
• Giannobile WV, Jung RE, Schwarz F, Groups of the 2nd Osteology Foundation Consensus M. Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus Report Part 1-Effects of soft tissue augmentation procedures on the maintenance of peri-implant soft tissue health. Clin Oral Implants Res 2018;29 Suppl 15:7-10.
• Lin GH, Chan HL, Wang HL. The significance of keratinized mucosa on implant health: a systematic review. J Periodontol 2013;84:1755-1767.
• Souza AB, Tormena M, Matarazzo F, et al. The influence of peri-implant keratinized mucosa on brushing discomfort and peri-implant tissue health. Clin Oral Implants Res 2016;27:650-655.
• Baltacioglu E, Bagis B, Korkmaz FM, et al. Peri-Implant Plastic Surgical Approaches to Increasing Keratinized Mucosa Width. J Oral Implantol 2015;41:e73-81.
• Chackartchi T, Romanos GE, Sculean A. Soft tissue-related complications and management around dental implants. Periodontol 2000 2019;81:124-138.
• Langer B, Sullivan DY. Osseointegration: its impact on the interrelationship of periodontics and restorative dentistry. Part 3. Periodontal prosthesis redefined. Int J Periodontics Restorative Dent 1989;9:240-261.
• Langer B, Langer L. Overlapped flap: a surgical modification for implant fixture installation. Int J Periodontics Restorative Dent 1990;10:208-215.
• Wennstrom JL, Derks J. Is there a need for keratinized mucosa around implants to maintain health and tissue stability? Clin Oral Implants Res 2012;23 Suppl 6:136-146.
• Esposito M, Maghaireh H, Grusovin MG, et al. Soft tissue management for dental implants: what are the most effective techniques? A Cochrane systematic review. Eur J Oral Implantol 2012;5:221-238.
• Heitz-Mayfield LJ. Peri-implant diseases: diagnosis and risk indicators. J Clin Periodontol 2008;35:292-304.
• Roccuzzo M, Grasso G, Dalmasso P. Keratinized mucosa around implants in partially edentulous posterior mandible: 10-year results of a prospective comparative study. Clin Oral Implants Res 2016;27:491-496.
• Cairo F, Pagliaro U, Nieri M. Soft tissue management at implant sites. J Clin Periodontol 2008;35:163-167.
• Thoma DS, Benic GI, Zwahlen M, et al. A systematic review assessing soft tissue augmentation techniques. Clin Oral Implants Res 2009;20 Suppl 4:146-165.
• Lin CY, Chen Z, Pan WL, et al. Impact of timing on soft tissue augmentation during implant treatment: A systematic review and meta-analysis. Clin Oral Implants Res 2018;29:508-521.
• Hamurcu N, Tunç S, Binici K, et al. Augmentation of Implant Sites with Insufficient Keratinised Mucosa by Autogenous Soft Tissue Grafting. KSU Medical Journal 2020;15:116-124.
• Bassetti RG, Stahli A, Bassetti MA, et al. Soft tissue augmentation around osseointegrated and uncovered dental implants: a systematic review. Clin Oral Investig 2017;21:53-70.
• Bassetti RG, Stahli A, Bassetti MA, et al. Soft tissue augmentation procedures at second-stage surgery: a systematic review. Clin Oral Investig 2016;20:1369-1387.