种植位点角化龈增量的时机和术式考量  

Timing and surgery option of keratinized mucosa augmentation around implant site

作　　者：杨杭 倪杰 陆薇 李晓军[2] 何福明[1] Yang Hang;Ni Jie;Lu Wei;Li Xiaojun;He Fuming(Department of Prosthodontics,Stomatology Hospital,School of Stomatology,Zhejiang University School of Medicine&Clinical Research Center for Oral Diseases of Zhejiang Province&Key Laboratory of Oral Biomedical Research of Zhejiang Province&Cancer Center of Zhejiang University,Hangzhou 310006,China;Department of Periodontology,Stomatology Hospital,School of Stomatology,Zhejiang University School of Medicine&Clinical Research Center for Oral Diseases of Zhejiang Province&Key Laboratory of Oral Biomedical Research of Zhejiang Province&Cancer Center of Zhejiang University,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属口腔医院修复科·浙江大学口腔医学院,浙江省口腔疾病临床医学研究中心,浙江省口腔生物医学研究重点实验室,浙江大学癌症研究院,杭州310006 [2]浙江大学医学院附属口腔医院牙周科·浙江大学口腔医学院,浙江省口腔疾病临床医学研究中心,浙江省口腔生物医学研究重点实验室,浙江大学癌症研究院,杭州310006

出　　处：《中华口腔医学杂志》2024年第2期182-190,共9页Chinese Journal of Stomatology

基　　金：国家自然科学基金(82271026,82201114);浙江大学医学院附属口腔医院探索与研发项目(RD2022DLYB02)。

摘　　要：近年,种植位点周围2 mm角化龈宽度(KMW)的生物学作用和美学作用已逐渐受到重视,如何对角化龈不足的患者进行增量受到临床医师越来越广泛的关注。游离龈移植(FGG)是角化龈增量的金标准,但种植术前、种植手术同期、种植体骨整合期、种植二期手术以及修复负载后还可根据不同的适应证使用位点保存术(ARP)、上皮下结缔组织移植(CTG)以及根向复位瓣(APF)等方式获得2 mm以上的角化龈增量效果。本文总结对种植患者不同时期进行角化龈增量的考量因素以及术式选择,以期为种植体周围角化龈不足的防治策略提供参考。In recent years,clinicians have paid more attention to the biological and esthetic effects of the 2 mm keratinized mucosa width(KMW)around dental implant.How to increase the keratinized mucosa is the focus of clinicians.While the free gingival graft(FGG)is still the gold standard of keratinized mucosa augmentation,alveolar ridge preservation(ARP),connective tissue graft(CTG)and apically positioned flap(APF)can also be used to obtain more than 2 mm keratinized mucosa width when they are used before implantation,with implantation,within the implant-healing phase,with second stage of implantation or after rehabilitation according to different indications.This article comprehensively summarizes the influencing factors of timing and surgical procedures for keratinized mucosa augmentation,providing guidance for clinicians to treat peri-implant keratinized mucosa deficiencies.

关 键 词：牙种植 牙龈 美学 牙科 角化龈增量 游离龈移植 上皮下结缔组织移植 根向复位瓣 

分 类 号：R783.6[医药卫生—口腔医学]