Utjecaj mekih tkiva na estetski izgled pacijenta

professional thesis

• Title (english): The influence of the soft tissues on the esthetic appearance
• Author: Filip Pezer
• Mentor: Darko Božić (mentor)
• Committee member: Anja Baraba (predsjednik povjerenstva)
• Committee member: Darko Božić (član povjerenstva)
• Committee member: Ana Badovinac (član povjerenstva)
• Committee member: Ivan Puhar (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Periodontology); Zagreb
• Defense date and country: 2022-12-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Doktori dentalne medicine svakodnevno su izloženi estetskim zahtjevima pacijenta.
Napretcima u parodontologiji i implantologiji estetici tvrdih i mekih potpornih tkiva sve se više
pridaje pozornost. Na estetiku mekih tkiva oko zuba utječu boja, vidljivost gingive prilikom
osmijeha, recesije gingive i crni trokuti. Upaljenu gingivu karakterizira tamnija lividna boja
koja se inicijalnom terapijom vraća u bljedoružičastu. Alterirana pasivna erupcija,
hipermobilnost gornje usne ili pretjerani vertikalni rast maksile uzroci su gingivnog osmijeha.
Terapija je usmjerena na eliminaciju uzročnog čimbenika. Recesija gingive pomicanje je ruba
gingive apikalno od caklinsko-cementnog spojišta. Mnogo je različitih tehnika za prekrivanje
recesija s različitim uspjesima, od kojih je koronalno pomaknuti režanj u kombinaciji s
vezivnotkivnim transplantatom najuspješniji. Crni trokuti prisutni su kada je udaljenost od
interproksimalne kontaktne točke do vrha interdentalne alveolarne kosti veći od 5 milimetara.
Najučinkovitiji način zatvaranja crnih trokuta jest pomicanje kontaktne točke između zuba
apikalno restaurativnim ili protetskim postupcima. Nadomještanje izgubljenih zuba u estetskoj
zoni implantatima zahtijeva razumijevanje dimenzionalnih promjena koštanih i mekih tkiva
nakon ekstrakcije zuba. Recesija oko implantata čest je estetski problem koji se kirurški može
uspješno riješiti. Za prevenciju recesija i crnih trokuta oko implantata naglašena je važnost
očuvanja ili rekonstrukcije keratinizirane gingive te pravilno pozicioniranje implantata prilikom
njihove ugradnje. Periimplantitis je jedna od najčešćih komplikacija oko dentalnih implantata,
što može rezultirati estetskim problemom. U estetskoj zoni poželjno je za kiruršku terapiju
periimplantitisa koristiti regenerativne postupke. Za nadomještanje zubi implantatima u
prednjoj maksili minimalno invazivni postupci kao socket shield tehnika pokazali su se iznimno
korisni s odličnim estetskim rezultatima.

Abstract (english)

Patients nowadays have increasing esthetic demands. Esthetics of the soft tissues have gained
more attention because of the advances in periodontology and implantology. Factors affecting
soft tissue esthetics are color, appearance of the gingiva while smiling, gingival recessions and
black triangles. Inflamed gingiva is characterized by a darker livid color. After initial
periodontal therapy, the color returns to pale pink. Altered passive eruption, hypermobility of
the upper lip or excessive vertical maxillary growth can cause a gummy smile. The treatment
of choice is aimed to remove the cause of the gummy smile. Gingival recessions are described
as the apical shift of the gingival margin apical from the cemento-enamel junction. There are
many described techniques of covering gingival recessions with varying degrees of success. A
coronally advanced flap combined with a connective tissue graft has been proven the most
successful. Black triangles are present when the distance from the interproximal contact point
to the alveolar bone crest is greater than 5 millimeters. The most effective treatment of black
triangles is relocating the interproximal contact point apically in a restorative or prosthetic
manner. Tooth extraction results in significant dimensional changes in bone and the
surrounding soft tissues. Understanding those dimensional changes is important for the
successful replacement of lost teeth with dental implants. Recessions around implants are a
common esthetic problem. Some surgical techniques have shown to be effective in covering
recessions around implants. Preserving or restoring the keratinized gingiva combined with the
correct positioning of the implant are important for the prevention of recessions and black
triangles around implants. Peri-implantitis is one of the most common complications regarding
dental implants. Severe peri-implant lesions could result in an esthetic problem. Regenerative
procedures are preferable for the surgical treatment of peri-implantitis in the esthetic zone.
Minimally invasive procedures, such as the socket shield technique, have been proven useful
in replacing teeth with implants in the anterior maxilla, with excellent esthetic results.

• Keywords: povlačenje gingive; dentalna estetika; zubni implantati
• Keywords (english): Gingival Recession; Dental Esthetic; Dental Implants
• Language: croatian
• URN:NBN: urn:nbn:hr:127:895876
• 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: 2022-12-15 09:54:36