CHANGES IN GUM BIOTYPE IN THE PROJECTION OF DENTAL IMPLANTS
Abstract and keywords
Abstract (English):
Deficiency of keratinized gum in the peri-implant zone contributes to bone recession and visualization of implant necks and abutments through its thin layer. To develop clinically effective and scientifically based protocols for the prevention and treatment of pathology of tissues surrounding implants, it is necessary to study the risk factors for the occurrence of mucositis and peri-implantitis, one of which is the deficiency or complete absence of attached keratinized gum in the implant area, as a result of which the mobile mucous membrane is constantly displaced during eating, talking, performing hygiene procedures. The gums are easily injured, which leads to rapid colonization of pathogenic microflora and the development of initial inflammation in the form of mucositis. The inflammatory process is launched, which in turn leads to an increase in the activity of osteoclasts. It should be noted that the rate of development of the inflammatory process in the area of implants is much higher than in the area of teeth. Due to the absence of the periodontal ligament, the inflammatory infiltrate directly spreads to the alveolar bone and penetrates into the medullary spaces. The gum contour in the area of installed implants must be aesthetic, stable and dense. This together will not only provide a cosmetic effect, but will also prevent the development of early and late complications of dental implantation. The paper provides an analysis of various methods of mucogingival surgery in the field of dental implants using an allogeneic graft of the “Alloplant” series. Engraftment of mucosal autografts from the tubercle of the upper jaw after surgery is accompanied by severe inflammation, which can lead to scarring of the mucosa or exposure of the bone. Allografts transplanted to patients to thicken the gums in the area of implantation are completely replaced after 6 months without signs of rejection or inflammatory processes by a full-fledged connective tissue regenerate covered with stratified squamous keratinizing epithelium. In the surgical area, gum tissue is formed in thickness, which can be classified as a “thick” gum phenotype.

Keywords:
biotype of the mucous membrane, implant, attached gum, alloplant, autograft
References

1. Dayronas S.K., Dayronas E.G., Melenberg T.V. Mestnoe obezbolivanie i anesteziologiya v stomatologii. Kratkiy kurs lekciy. Uchebnoe posobie. Samara : Medicinskiy universitet «REAVIZ». 2019:172. [S.K. Dayronas, E.D. Dayronas, T.V. Melenberg. Local anesthesia and anesthesiology in dentistry. A short course of lectures. Tutorial. Samara: Medical University "REAVIZ". 2019:172. (In Russ.)]. https://reaviz.ru/sveden/files/RP_discipliny_Mestnoe_obezbolivanie_i_anesteziologiya_v_stomatologii(1).pdf

2. Deniev A.M. Dental'naya implantaciya posle rekonstruktivnyh operaciy s primeneniem revaskulyarizirovannyh autotransplantatov : avtoref. dis. ... kandidata medicinskih nauk. 14.01.14. Moskva, 2019:26. [A.M. Deniev. Dental implantation after reconstructive operations using revascularized autografts : abstract of thesis. dis. ... candidate of medical sciences. 14.01.14. Moscow, 2019:26. (In Russ.)]. https://www.dissercat.com/content/kliniko-laboratornoe-obosnovanie-novoi-tekhnologii-vestibuloplastiki-pri-formirovanii-periim

3. Kuri F. Regenerativnye metody v implantologii. Moskva : Azbuka stomatologov. 2013:678. [F. Kuri. Regenerative methods in implantology. Moscow : ABC of dentists. 2013:678. (In Russ.)]. https://kingmed.info/knigi/Stomatologiya/Hirurgicheskaya_stomatologiya/book_4276/Regenerativnie_metodi_v_implantologii-Kuri_F_Hanzer_T_Kuri_Ch-2013-pdf

4. Muldashev E.R. Teoreticheskie i prikladnye aspekty sozdaniya allotransplantantov serii «Alloplant» dlya plasticheskoy hirurgii lica : avtorefer. dis. … d-ra med. nauk. SPb., 1994:40. [E.R. Muldashev. Theoretical and applied aspects of creating allografts of the “Alloplant” series for facial plastic surgery: abstract. Dis. … dr. med. Sciense. St. Petersburg, 1994:40. (In Russ.)]. https://www.rmj.ru/articles/obshchie-stati/Primenenie_biomateriala_Alloplant_v_hirurgii_neyrofibromatoza_vek_1/

5. Musienko A.I., Nesterova K.I. Nemedlennaya implantaciya pri hronicheskom generalizovannom parodontite i apikal'noy granuleme. Parodontologiya. 2019;24(2):145-149. [A.I. Musienko, K.I. Nesterova. Immediate implantation for chronic generalized periodontitis and apical granuloma. Periodontology. 2019;24(2):145-149. (In Russ.)]. https://www.parodont.ru/jour/article/view/239?locale=ru_RU

6. Musina L.A., Muslimov S.A., Lebedeva A.I., Volgareva E.A. Ul'trastruktura makrofagov, vyyavlyaemyh pri implantacii allogennogo biomateriala Alloplant. Morfologiya. 2006;1:53-56. [L.A. Musina, S.A. Muslimov, A.I. Lebedeva, E.A. Volgareva. Ultrastructure of macrophages detected during implantation of allogeneic biomaterial Alloplant. Morphology. 2006;1:53-56. (In Russ.)]. https://cyberleninka.ru/article/n/biomaterial-alloplant-pri-regeneratsii-miometriya-roga-matki-eksperimentalnyh-zhivotnyh-stimulyator-makrofagov-mezenhimnogo

7. Musina L.A. Funkcional'naya morfologiya makrofagov pri regeneracii tkaney, inducirovannoy allogennymi biomaterialami : avtorefer. Dis. … d-ra biol.nauk. Saransk, 2007:49. [L.A. Musina. Functional morphology of macrophages during tissue regeneration induced by allogeneic biomaterials : abstract. dis. ... Doctor of Biological Sciences. Saransk, 2007:49. (In Russ.)]. https://www.dissercat.com/content/funktsionalnaya-morfologiya-makrofagov-pri-regeneratsii-tkanei-indutsirovannoi-allogennymi-b

8. Musina L.A., Muslimov S.A., Lebedeva A.I. Stimulyaciya regeneracii tkaney allogennymi biomaterialami. Morfologiya. Sankt-Peterburg : Eskulap. 2012;3:109-110. [L.A. Musina, S.A. Muslimov, A.I. Lebedeva. Stimulation of tissue regeneration with allogeneic biomaterials. Morphology. St. Petersburg : Aesculapius. 2012;3:109-110. (In Russ.)]. https://izd-mn.com/PDF/39MNNPK20.pdf

9. Muslimov S.A. Morfologicheskie aspekty regenerativnoy hirurgii. Ufa : Bashkortostan. 2000:168. [S.A. Muslimov. Morphological aspects of regenerative surgery. Ufa: Bashkortostan. 2000:168. (In Russ.)]. https://www.alloplant.ru/upload/iblock/b36/mjjq68a7r2tau4y5boyugv1uvmkrss27.pdf

10. Palachchi P. Plastika myagkih tkaney v oblasti implantatov. Parodontologiya i restavracionnaya stomatologiya. 2012;7:161-177. [P. Palacci. Plastic surgery of soft tissues in the area of implants. Periodontics and restorative dentistry. 2012;7:161-177. (In Russ.)]. https://cyberleninka.ru/article/n/profilaktika-rezorbtsii-kostnoy-tkani-v-periimplantatnoy-zone-putem-primeneniya-soedinitelno-tkannogo-transplantata-na-pitayuschey

11. Perova M.D. Tkani paradonta: norma, patologiya, puti vosstanovleniya. Moskva. 2005:312. [M.D. Perova. Periodontal tissues: norm, pathology, ways of restoration. Moscow. 2005:312. (In Russ.)]. https://www.combook.ru/product/11964785/

12. Reshetnikov A.P., Nikityuk D.B., Urakov A.L. Sposob ustraneniya nedostatochnosti myagkih tkaney vokrug ustanovlennogo implantata. Zayavka na izobretenie RUS № 201423087. 18.06.2014. [A.P. Reshetnikov, D.B. Nikityuk, A.L. Urakov. A method for eliminating soft tissue deficiency around an installed implant. Application for invention RUS No. 201423087. 06/18/2014. (In Russ.)]. https://edrid.ru/rid/216.013.6b2e.html

13. Robert Marks. Patologiya polosti rta i chelyustno-licevoy oblasti v praktike stomatologa. 2019. [Robert Marks. Pathology of the oral cavity and maxillofacial area in dental practice. 2019. (In Russ.)]. https://www.dental-azbuka.ru/books/kniga_195.html

14. Sel'skiy N.E., Musina L.A., Kozhemyakina E.S. Kliniko-eksperimental'noe issledovanie effektivnosti zakrytiya perforacii slizistoy obolochki pri operacii sinus-lifting s ispol'zovaniem allotransplantata dlya napravlennoy tkanevoy regeneracii. Ural'skiy medicinskiy zhurnal. 2014;7:100-103. [N.E. Selsky, L.A. Musina, E.S. Kozhemyakina. Clinical experimental study of the effectiveness of closing mucosal perforation during sinus lift surgery using an allograft for directed tissue regeneration. Ural Medical Journal. 2014;7:100-103. (In Russ.)]. https://cyberleninka.ru/article/n/kliniko-eksperimentalnoe-obosnovanie-effektivnosti-primeneniya-razlichnyh-tipov-materialov-pri-provedenii-operatsii-sinus-lifting/viewer

15. Tlustenko V.P., Bayrikov I.M., Trunin D.A., Gusyakova O.A., Komlev S.S. Vliyanie tehnologii protezirovaniya zubov na dinamiku rannih prediktorov vospalitel'no-destruktivnogo processa v periimplantnoy zone. Vestnik Rossiyskogo gosudarstvennogo medicinskogo universiteta. 2019;2. [V.P. Tlustenko, I.M. Bayrikov, D.A. Trunin, O.A. Gusyakova, S.S. Komlev. The influence of dental prosthetic technology on the dynamics of early predictors of the inflammatory-destructive process in the peri-implant zone. Bulletin of the Russian State Medical University. 2019;2. (In Russ.)]. https://cyberleninka.ru/article/n/vliyanie-tehnologii-protezirovaniya-zubov-na-dinamiku-rannih-prediktorov-vospalitelno-destruktivnogo-protsessa-v-periimplantatnoy/viewer

16. Yablokov A.E., Ivaschenko A.V., Fedyaev I.M. i dr. Osobennosti pozicionirovaniya dental'nyh implantatov. Medicinskiy alfavit. 2019;11(2):33-34. [A.E. Yablokov, A.V. Ivashchenko, I.M. Fedyaev et al. Features of positioning of dental implants. Medical alphabet. 2019;11(2):33-34. (In Russ.)]. https://samsmu.ru/files/referats/2020/yablokov/avtoreferat.pdf

17. Muldashev E.R., Muslimov S.A., Musina L.A., Nigmatullin R.T., Lebedeva A.I., Shangina O.R., Khasanov R.A. et al. The role of macrophages in the tissues regeneration stimulated by the biomaterials // Cell Tissue Bank. – 2005;6(2):99-107. file:///C:/Users/chea/Downloads/eksperimentalno-mopfologicheskoe-issledovanie-vliyaniya-dispepgipovannogo-allogennogo-biomateriala-na-pegeneratsiyu-pogovitsy.pdf


Login or Create
* Forgot password?