Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Clinical Implant Dentistry and Related Research Pub Date : 2024-02-28 DOI:10.1111/cid.13314

Leonardo Mancini, Franz J. Strauss, Hyun-Chang Lim, Lorenzo Tavelli, Ronald E. Jung, Nadja Naenni, Daniel S. Thoma

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Abstract

Aim

To investigate whether the lack of keratinized mucosa (KM) affects peri-implant health after 10 years of loading.

Materials and Methods

Data from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5-year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri-implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one-piece or two-piece) and compliance.

Results

A total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri-implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW >0 mm) 41.2% exhibited mucositis. Regarding peri-implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM >0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], p = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], p = 0.02) and using two-piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], p = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two-piece implants were associated with reduced MBL and MBL changes (p < 0.05).

Conclusion

The lack of buccal KM appears to be linked with peri-implant parameters such as BOP and MBL, but the association is weak. The design of one-piece implants may account for their increased odds of exhibiting BOP.

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角质化粘膜对种植体健康相关参数的影响：一项为期 10 年的前瞻性再分析研究。

目的：研究角化粘膜（KM）的缺乏是否会影响种植体植入 10 年后的种植体周围健康：纳入并分析了来自两项随机对照研究的 74 名患者的数据，这些患者共种植了 148 颗种植体，并对不同的种植体系统进行了比较。收集了基线（最终植入修复体时）、5 年和 10 年加载后的临床参数，包括探诊出血（BOP）、探诊深度（PD）、菌斑指数、边缘骨质流失（MBL）和颊侧 KM 宽度（KMW）。通过广义估计方程（GEE）建立多变量逻辑和线性回归模型，评估颊侧 KM 对种植体周围临床参数（BOP、MBL、PD）的影响，并根据种植体类型（一片式或两片式）和顺应性进行调整：共有 35 个（24.8%）种植体健康，67 个（47.5%）患有粘膜炎，39 个（27.6%）患有种植体周围炎。在没有口腔黏膜的情况下（KM = 0 mm），75%的种植体表现出黏膜炎，而在有口腔黏膜的情况下（KMW > 0 mm），41.2%的种植体表现出黏膜炎。至于种植体周围炎，相应的比例分别为 20%（KM = 0 毫米）和 26.7%（KM > 0 毫米）。未经调整的逻辑回归显示，颊面 KM 的存在往往会降低颊面部位出现 BOP 的几率（OR：0.28 [95% CI，0.07 至 1.09]，p = 0.06）。调整后的逻辑回归模型显示，颊侧 KM（OR：0.21 [95% CI，0.05 至 0.85]，p = 0.02）和使用两件式种植体（OR：0.34 [95% CI，0.15 至 0.75]，p = 0.008）可显著降低出现 BOP 的几率。通过 GEE 进行调整后的线性回归显示，KM 和两件式种植体与 MBL 和 MBL 变化的减少有关（p 结论：KM 和两件式种植体与 MBL 变化的减少有关：颊面 KM 的缺乏似乎与 BOP 和 MBL 等种植体周围参数有关，但关联性较弱。一体式种植体的设计可能是其表现出 BOP 的几率增加的原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.