慢性牙周炎易感患者种植体周围角化黏膜对种植体周软组织健康的影响  

Influence of keratinized mucosa on peri-implant soft tissue health among patients with chronic periodontitis susceptibility

作　　者：钱洁蕾[1] 束蓉[1] 王依玮[1] 谢玉峰[1] QIAN Jie-lei;SHU Rong;WANG Yi-wei;XlE Yu-feng(Shanghai Key Laboratory of Stomatology,Department of Periodontology,Shanghai Ninth People＇s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院牙周科上海市口腔医学重点实验室,上海200011

出　　处：《上海交通大学学报（医学版）》2018年第8期929-933,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金面上项目(81570977);上海市科学技术委员会医学重点项目(13411951300);上海市教育委员会高峰高原学科建设计划~~

摘　　要：目的·观察慢性牙周炎患者种植修复后种植体周围角化黏膜对种植体周围软组织健康和稳定性的影响。方法·收集2010年8月—2013年11月接受种植修复的慢性牙周炎患者58例(158枚种植体),观察植入后4年软组织的情况,对不同角化黏膜宽度的种植体发生种植体周围病变及黏膜退缩的情况进行比较分析。结果·在坚持定期随访维护的患者中,窄角化黏膜(narrow keratinized mucosa,NKM)组和宽角化黏膜(widekeratinized mucosa,WKM)组的种植体周围黏膜炎和种植体周围炎的发生率差异均无统计学意义(P=0.862,P=0.625)。角化黏膜的宽窄对改良菌斑指数和改良出血指数也无显著影响(P=0.826,P=0.913)。但当角化黏膜宽度≥2 mm(即WKM组)时,种植体周黏膜不易发生退缩。WKM组厚生物型的黏膜退缩发生率(12.86%)显著低于WKM组薄生物型(33.33%)及NKM组厚生物型(40.63%)的黏膜退缩发生率(P=0.049,P=0.002)。结论·角化黏膜对于慢性牙周炎易感患者的种植体周软组织具有稳定作用,足够宽度的角化黏膜可以预防种植体周围黏膜发生退缩。Objective·To observe the influence of keratinized mucosa on peri-implant soft tissue health and stability after implant treatment among patients with chronic periodontitis. Methods·Fifty-eight patients with chronic periodontitis（158 implants） who received implant treatment were enrolled from Aug. 2010 to Nov. 2013. The soft tissue conditions were observed, the peri-implant disease rate and mucosa recession rate were compared between patients in different keratinized mucosa groups. Results·The differences of rates of peri-implant mucositis and peri-implatitis between the narrow keratinized mucosa（NKM） group and wide keratinized mucosa（WKM） group were not statistically significant（P=0.862, P=0.625）. The effects of the width of the keratinized mucosa on modified plaque index and modified bleeding index were not significant（P=0.826, P=0.913）. When the width of the keratinized mucosa ≥ 2 mm, the recession of mucosa is not evident. The recession incidence of the thick and wide mucosa was 12.86%, which was significantly lower than that of the thin and wide mucosa（33.33%） and that of thick and narrow mucosa（40.63%）（P=0.049, P=0.002）. Conclusion·Keratinized mucosa has a positive effect on peri-implant tissue stability among patients with chronic periodontitis susceptibility. The keratinized mucosa with sufficient width can prevent the mucosa from recession.

关 键 词：种植体 角化黏膜 种植体周围病 牙周炎 生物型 

分 类 号：Q78[生物学—分子生物学]