Produbljenje vestibuluma distalne mandibule uz slobodni gingivni transplantat kao priprema za implantoprotetsku terapiju - prikaz slučaja

postgraduate specialist thesis

• Title (english): Deepening of the vestibule of the distal mandible with a free gingival graft as preparation for implant-prosthetic therapy - case report
• Author: Stjepanka Lešić
• Mentor: Domagoj Vražić (mentor)
• Committee member: Darko Božić (predsjednik povjerenstva)
• Committee member: Domagoj Vražić (član povjerenstva)
• Committee member: Ivan Puhar (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2024-03-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Implantoprotetska terapija zahtijeva detaljno i precizno planiranje kako bi se postigla optimalna funkcija, estetika i prirodnost budućeg protetskog nadomjestka. Svaka terapija započinje anamnezom i kliničkim pregledom s analizom fotografija, cone beam
kompjutoriziranom tomografijom ili ortopantomografske snimke. Slijedi pozicioniranje implantata u točno određenoj orofacijalnoj, meziodistalnoj i apikokoronalnoj dimenziji gdje je ključno sačuvati dovoljnu debljinu bukalne stjenke radi postizanja optimalne razine periimplantatne mukoze. Prilikom terapije pacijenata važno je preoperativno ispitati čimbenike rizika, kontrolu hiperglikemije, razinu oralne higijene, širinu i debljinu keratinizirane periimplantatne mukoze, čime se mogu spriječiti određena stanja koja mogu ugroziti dentalni implantat. Uloga pričvrsne gingive u održavanju parodontnog i periimplantatnog zdravlja do sada je opsežno istraživana, ali su dokazi bili dvosmisleni. Postoji opći konsenzus da se augmentacija gingive oko dentalnog implantata treba izvesti u slučajevima kada pacijent ne može održavati odgovarajuću kontrolu plaka, kada postoji recesija mekog tkiva i u pretprotetske svrhe. Postojeća literatura zagovara ≥2 mm širine keratiniziranog tkiva oko implantata, jer je njegova prisutnost povezana sa smanjenjem upale sluznice, nelagodom pri četkanju i količinom plaka. Augmentacija gingive s pomoću
slobodnog gingivnog transplantata je postupak „zlatnog standarda“ za povećanje količine keratiniziranog tkiva. Svrha je ovoga rada kroz prikaz slučaja prikazati primjenu tehnike slobodnog gingivnog transplantata u kirurškoj terapiji nedostatka pričvrsne gingive u lateralnom dijelu mandibule kao pripremu za implantoprotetsku terapiju bezubosti uz istovremeni kirurški zahvat produbljenja vestibluma, te kroz pregled recentne literature na tu temu prikazati trenutačne preporuke u liječenju.

Abstract (english)

Implant-prosthetic therapy requires detailed and precise planning to achieve optimal function, aesthetics, and naturalness of the future prosthetic replacement. Each therapy starts with anamnesis and clinical examination with the analysis of photographs, Cone Beam Computed Tomography, or orthopantomographic images. This is followed by the positioning of the implant in a precisely determined orofacial, mesiodistal, and apicocoronal dimension where it is crucial to maintain sufficient thickness of the buccal wall to achieve optimal levels of peri-implant mucosa. When treating patients, it is
important to preoperatively examine risk factors, control of hyperglycemia, level of oral hygiene, width, and thickness of the keratinized peri-implant mucosa, thereby preventing certain conditions that can endanger the dental implant. The role of the attached gingiva in maintaining periodontal and peri-implant health has been extensively researched, but the evidence has been ambiguous. There is a general consensus that gingival augmentation around a dental implant should be performed in cases where the patient cannot maintain adequate plaque control, when there is soft tissue recession, and for pre-prosthetic purposes. The existing literature advocates for ≥2 mm width of keratinized tissue around the implant, as its presence is associated with reduced mucosal inflammation, discomfort during brushing, and the amount of plaque. Augmentation of the gingiva using a free gingival graft is the “gold standard” procedure for increasing the amount of keratinized tissue. The purpose of this paper is to present the application of the free gingival graft technique in surgical therapy for the deficiency of the attached gingiva in the lateral part of the mandible as a preparation for implant-prosthetic therapy for edentulism with a simultaneous surgical procedure of deepening the vestibule, and to present current recommendations in treatment through a review of recent literature on the subject.

• Keywords: gubitak alveolarne kosti; zubna proteza podržana implantatima; vestibuloplastika
• Keywords (english): Alveolar Bone Loss; Dental Prosthesis-Implant Supported; Vestibuloplasty
• Language: croatian
• URN:NBN: urn:nbn:hr:127:090787
• Study programme: Title: Dental implantology; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni specijalist dentalne medicine (sveučilišni specijalist dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2024-08-28 10:40:48