中国口腔种植学杂志2025，Vol.30Issue(6)：549-556,8.DOI:10.12337/zgkqzzxzz.2025.12.007
上颌前牙区种植体周黏膜退缩的预防与处理
Prevention and management of maxillary anterior peri-implant soft tissue dehiscence
Wang Miaozhen 1Liu Feng 1Liu Yan 2Li Yi 1Zhan Yaling 1Liu Xinran1
作者信息
- 1. Clinical Division,Peking University School and Hospital of Stomatology&National Center for Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology,Beijing 100034,China
- 2. The Third Affiliated Hospital of the Air Force Medical University,Xi'an 710061,China
- 折叠
摘要
Abstract
Peri-implant mid-facial recession,characterized by gingival recession,abutment exposure,and"black triangle"formation,critically compromises esthetic outcomes.Specific predisposing and precipitating factors are as follows:buccal bone dehiscence or fenestration,a thin periodontal phenotype,and insufficient or absent keratinized mucosa;improper case selection for immediate implant placement,overly buccal implant positioning,excessively large implant or abutment diameters,and over-contoured restorations;as well as aggressive tooth brushing and inflammatory stimuli from peri-implant diseases.Preventive strategies for mid-facial recession must be integrated throughout the entire implant treatment cycle.Preoperatively,CBCT is utilized for precise planning of implant placement,and digitally guided surgery may be selected for accurate implantation.In immediate implant cases,it is recommended to combine jump gap bone grafting and connective tissue graft(CTG)intraoperatively to thicken the soft tissue.For early or delayed implantation,the focus shifts to preserving existing tissue and reconstructing lost tissue.This involves using standardized guided bone regeneration(GBR)techniques and tension-free suturing during bone augmentation to rebuild lost support.During the prosthetic phase,provisional and final prostheses with appropriate emergence profiles and biocompatible materials are used to effectively shape and support the soft tissue.For managing the existing recession,a graded treatment protocol is proposed as follows.Mild recession(<2 mm):Tunnel technique+CTG.Severe recession(≥2 mm):coronally advanced flap(CAF)+CTG.Cases with loss of interdental papilla:connective tissue platform technique.In summary,achieving long-term stable aesthetics requires strict adherence to clinical protocols,control of iatrogenic factors,and a combination of evidence-based decision-making with precise surgical execution.关键词
美学区/种植体周软组织开裂/缺损/正中黏膜退缩/结缔组织移植Key words
Esthetic zone/Peri-implant soft tissue dehiscence/deficiency/Mid-facial recession/Connective tissue graft引用本文复制引用
Wang Miaozhen,Liu Feng,Liu Yan,Li Yi,Zhan Yaling,Liu Xinran..上颌前牙区种植体周黏膜退缩的预防与处理[J].中国口腔种植学杂志,2025,30(6):549-556,8.
