种植体周游离龈移植术后收缩影响因素的研究进展

doi:10.13591/j.cnki.kqyx.2025.10.011

摘要/Abstract

摘要：

充足的角化黏膜对保证种植体的长期稳定及美观具有重要意义,如何有效对角化黏膜宽度不足的位点进行软组织增量逐渐成为当前的研究热点。根向复位瓣(apically positioned flap,APF)联合游离龈移植术(free gingival graft,FGG)被认为是种植体周角化黏膜增宽的首选治疗方法,但术后收缩现象及其影响因素尚不完全明确。本文旨在阐述角化黏膜对种植体周软硬组织健康的意义,分析影响FGG疗效的相关因素,总结提出FGG术后收缩的风险因素评估表,以期为口腔临床医师提供科学、有效的种植体周围软组织管理参考。

关键词: 种植体, 角化黏膜宽度, 软组织增量术, 游离龈移植, 收缩率

Abstract:

Sufficient keratinized mucosa is important for ensuring the long-term stability and aesthetics of dental implants. How to effectively augment the soft tissue volume at sites with insufficient keratinized mucosa width (KMW) has gradually become a hot research topic for current scholars. Apically positioned flap (APF) with free gingival graft (FGG) is recognized as the approach of choice for peri-implant keratinized mucosal augmentation, but the postoperative shrinkage and its influencing factors are not completely clear. The objective of this review is to explain the significance of keratinized mucosa to peri-implant tissue health, analyze the relevant factors affecting postoperative contraction of free gingival grafts, and finally propose a risk factor assessment table for postoperative shrinkage of FGG, with the aim of providing clinicians with a scientific and effective strategy for peri-implant soft tissue management.

Key words: dental implant, keratinized mucosa width, soft tissue augmentation, free gingival graft, shrinkage rate

中图分类号:

R783.4

鲍思琦, 陈龙, 倪杰, 姒蜜思. 种植体周游离龈移植术后收缩影响因素的研究进展[J]. 口腔医学, 2025, 45(10): 783-788.

BAO Siqi, CHEN Long, NI Jie, SI Misi. Research progress of factors affecting postoperative contraction of peri-implant free gingival grafts[J]. Stomatology, 2025, 45(10): 783-788.

图/表 1

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风险因素	低风险	中风险	高风险
移植时机^a	种植前;组织整合期	Ⅱ期同期	修复后
局部解剖因素^b
邻牙附着龈宽度/mm	≥3	1~3	≤1
前庭沟底位置	远离牙槽嵴顶	—	邻近牙槽嵴顶
牙槽嵴高度降低	无明显降低	<3 mm	≥3 mm
缺牙部位	前牙区	前磨牙区、上颌磨牙区	下颌磨牙区
缺牙间隙大小	1个牙位	2个牙位	>2个牙位
是否游离端	否	—	是
移植物的尺寸^c
厚度/mm	1~1.5	—	<0.75 或 >2
大小/mm²	<100	100~150	>150
吸烟习惯^c	不吸烟	少量吸烟(≤10 支/d)	大量吸烟(>10支/d)