근단변위판막술과 함께 유리치은이식술을 사용하여 임플란트 주변 각화치은을 증대시킨 2건의 증례 보고
Free gingival graft in combination with apically positioned flap for establishment of keratinized gingiva around the implants: Report of two cases
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.
Abstract
Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.
참고문헌 (23)
- Lang NP, "The relationship between the width of keratinized gingiva and gingival health", J Periodontol, 43(10), pp.623~627 (1972)
- Miyasato M, "Gingival condition in areas of minimal and appreciable width of keratinized gingiva", J Clin Periodontol, 4(3), pp.200~209 (1977)
- Friedman L, "Mucogingival surgery:Current status", J Periodontol, 35, pp.5~21 (1964)
- Ochsenbein C, "Newer concept of mucogingival surgery", J Periodontol, 31, pp.175~185 (1960)
- Adell R, "Marginal tissue reactions at osseointegrated titanium fixtures (I). A 3-year longitudinal prospective study", Int J Oral Maxillofac Surg, 15(1), pp.39~52 (1986)
- Bouri A, Jr., "Width of keratinized gingiva and the health status of the supporting tissues around dental implants", Int J Oral Maxillofac Implants, 23(2), pp.323~326 (2008)
- Schrott AR, "Five-year evaluation of the influence of keratinized mucosa on peri-implant soft-tissue health and stability around implants supporting full-arch mandibular fixed prostheses", Clin Oral Implants Res, 20(10), pp.1170~1177 (2009)
- Heitz-Mayfield LJ, "Consensus statements and clinical recommen dations for prevention and management of biologic and technical implant complications", Int J Oral Maxillofac Implants, (29 Suppl), pp.346~350 (2014)
- Basegmez C, "The comparison of acellular dermal matrix allografts with free gingival grafts in the augmentation of peri-implant attached mucosa: a randomised controlled trial", Eur J Oral Implantol, 6(2), pp.145~152 (2013)
- Sanz M, "Clinical evaluation of a new collagen matrix (Mucograft prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations:a randomized prospective clinical trial", J Clin Periodontol, 36(10), pp.868~876 (2009)
- Carnio J, "Increasing the apico-coronal dimension of attached gingiva using the modified apically repositioned flap technique: a case series with a 6-month follow-up", J Periodontol, 78(9), pp.1825~1830 (2007)
- Thoma DS, "Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review", J Clin Periodontol, 41(Suppl 15), pp.S77~S91 (2014)
- Landi L, "Plastic surgery at the time of membrane removal around mandibular endosseous implants: a modified technique for implant uncovering", Int J Periodontics Restorative Dent, 21(3), pp.280~287 (2001)
- Han TJ, "The strip gingival autograft technique", Int J Periodontics Restorative Dent, 13(2), pp.180~187 (1993)
- 박정철, "A simple approach to preserve keratinized mucosa around implants using a pre-fabricated implantretained stent: a report of two cases", Journal of Periodontal & Implant Science, 40(4), pp.194~200 (2010), 대한치주과학회
- Hassani A, "Free gingival graft immobilization: a pilot study on a newly designed stent", J Oral Implantol, 36(2), pp.123~130 (2010)
- Araujo MG, "Dimensional ridge alterations following tooth extraction. An experimental study in the dog", J Clin Periodontol, 32(2), pp.212~218 (2005)
- 손주연, "Simultaneous placement of an interpositional free gingival graft with nonsubmerged implant placement", Journal of Periodontal & Implant Science, 44(2), pp.94~99 (2014), 대한치주과학회
- Cortellini P, "Does placement of a connective tissue graft improve the outcomes of coronally advanced flap for coverage of single gingival recessions in upper anterior teeth? A multi-centre, randomized, double-blind, clinical trial", J Clin Periodontol, 36(1), pp.68~79 (2009)
- Park JB, "Increasing the width of keratinized mucosa around endosseous implant using acellular dermal matrix allograft", Implant Dent, 15(3), pp.275~281 (2006)
- Schmitt CM, "Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft ) versus the free gingival graft: a comparative prospective clinical trial", Clin Oral Implants Res, 00, pp.1~9 (2015)
- Cairo F, "Coronally advanced flap with and without connective tissue graft for the treatment of single maxillary gingival recession with loss of inter-dental attachment. A randomized controlled clinical trial", J Clin Periodontol, 39(8), pp.760~768 (2012)
- Agudio G, "Free gingival grafts to increase keratinized tissue: a retrospective long-term evaluation (10 to 25 years)of outcomes", J Periodontol, 79(4), pp.587~594 (2008)
