Augmentacija keratinizirane mukoze oko dentalnih implantata u donjoj čeljusti kod pacijenta koji boluje od dijabetesa tipa 2 - prikaz slučaja

professional thesis

• Title (english): Augmentation of keratinized periimplant mucosa in the lower jaw in a patient with type 2 diabetes - a case report
• Author: Dragan Andrić
• Mentor: Domagoj Vražić (mentor)
• Committee member: Ivan Puhar (predsjednik povjerenstva)
• Committee member: Domagoj Vražić (član povjerenstva)
• Committee member: Samir Čimić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2021-05-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Upalni procesi u tkivima oko implantata definiraju se kao periimplantatne bolesti, koje se mogu
podijeliti na periimplantatni mukozitis i periimplantitis. Kliničke karakteristike periimplantatnog
mukozitisa odgovaraju onima gingivitisa, uključuju simptome krvarenja i oticanja, dok se za
dijagnosticiranje periimplantitisa pored navedenih simptoma, mora potvrditi i resorpcija kosti
rendgenskom snimkom. Postoje sistemski i lokalni čimbenici nastanka periimplantatnih bolesti.
Prilikom tretmana pacijenata s dijabetes melitusom važno je preoperativno ispitati čimbenike
rizika, kontrolu hiperglikemije, razinu oralne higijene, širinu i debljinu keratinizirane
periimplantatne mukoze, čime se mogu spriječiti određenja stanja koja mogu ugroziti dentalni
implantat.
Pacijent, 57 godina, nepušač, boluje od dijabetes melitusa tipa 2 koji je pod internističkom
kontrolom, dolazi na redovitu implantološku kontrolu nakon 6 mjeseci te se uočava promjena
pričvrsne gingive oko implantatana na poziciji zuba 43 i 33. Kliničkim pregledom uočeni su
upalni znakovi, kao što je crvenilo, oteklina i krvarenje pri sondiranju. Navedeni simptomi
upućuju na dijagnozu periimplantatnog mukozitisa, odnosno periimplantitisa u slučaju
implantata na poziciji 33 uz rendgenski nalaz koštanog gubitka. Nedostatak dovoljnog volumena
keratinizirane periimplantatne mukoze dovodi do lakšeg nakupljanja bakterija te brže nastaju
upalne promjene zbog otežanog provođenja ispravne oralne higijene.
Pristupilo se terapiji periimplantatnih bolesti prema CIST protokolu kako bi se pacijenta
pripremilo za operativni zahvat slobodnim gingivalnim transplantatom s ciljem povećanja širina
keratinizirane periimplantatne mukoze. Nakon cijeljenja očekuje se povećanje volumena
keratinizirane gingive oko implantata i sprečavanje nastanka upalnih procesa uz odgovarajuću
oralnu higijenu.

Abstract (english)

Inflammatory processes in the tissues around the implant are defined as peri-implant diseases,
which can be divided into peri-implant mucositis and peri-implantitis. The clinical features of
peri-implant mucositis correspond to those of gingivitis, including symptoms of bleeding and
swelling, while for the diagnosis of peri-implantitis, in addition to the listed symptoms, bone
resorption must be confirmed by X-ray. There are systemic and local factors for the development
of peri-implant disease. When treating patients with diabetes mellitus, it is important to assess the
patient's preoperative risk factors, control of hyperglycemia, level of oral hygiene, and width and
thickness of the keratinized peri-implant mucosa, which can prevent the conditions that may
jeopardize the dental implant.
The patient, 57 years old woman, non - smoker, suffering from type 2 diabetes mellitus under
internal control, came for regular implant examination after 6 months, and changes in the attached
gingiva around the implant at the position of teeth 43 and 33 were noticed. Clinical examination
revealed inflammatory signs of redness, swelling, and bleeding on probing. The observed
symptoms are characteristic for the diagnosis of peri-implant mucositis or peri-implantitis in the
case of implants at position 33 with X-ray finding of bone loss. The lack of a sufficient volume of
keratinized peri-implant mucosa leads to easier accumulation of bacteria and inflammatory
changes due to the difficulty of proper oral hygiene.
Peri-implant disease therapy was approached according to the CIST protocol to prepare the
patient for the free gingival graft surgery to increase the width of the keratinized peri-implant
mucosa. After healing, an increase in the volume of keratinized gingiva around the implant is
expected, thus preventing the occurrence of inflammatory processes with proper oral hygiene.

• Keywords: zubni implantat; periimplantitis; dijabetes tipa 2; gingivalno krvarenje
• Keywords (english): Dental implants; peri-implantitis; diabetes mellitus type 2; gingival hemorrhage
• Language: croatian
• URN:NBN: urn:nbn:hr:127:241506
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra dentalne medicine (sveučilišni/a magistar/magistra dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-06-25 11:10:14