3D打印黏膜压迫式手术支架联合缝线锚定系统用于种植体周围角化黏膜增量的概念验证前瞻性单队列研究
3D printed mucocompressive surgical stent with suture-anchor system for peri-implant keratinized mucosa augmentation: A proof-of-concept prospective single-cohort study.
文献信息
| PMID | 42816247 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Dan Yu |
| 作者单位 | Professor, Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China. |
| 期刊 | The Journal of prosthetic dentistry |
| SCI 分区 | Q1 |
| IF | 5.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
问题陈述： 重建颌骨中种植体周围软组织条件不佳，对种植体的长期成功率构成挑战。尽管已有多种重建颌骨种植体周围软组织管理技术的报道，但评估其术后效果的研究仍缺乏。
目的： 本前瞻性单队列研究旨在通过使用定制的一组临时种植体支持式修复体和黏膜压迫式手术支架（IISP-MCSS）联合缝线锚定系统（SAS）在二次手术中优化重建颌骨的种植体周围角化黏膜增量（KMA），并评估其临床效果。
材料与方法： 4例采用游离腓骨瓣（FFF）进行下颌骨重建的患者接受了IISP-MCSS+SAS辅助的KMA手术。该手术包括根向复位瓣或前庭成形术（APF/V）以及游离上皮咀嚼黏膜移植（FEG）。在KMA术前（T0）、KMA术后即刻（T1）、4周（T2）和12周（T3）记录角化黏膜宽度（KMW）和前庭深度（VD）。采用视觉模拟量表（VAS）评估术后疼痛。计算KMW收缩率以及VD增加或退缩率，并使用配对t检验进行统计分析，同时进行双因素重复测量方差分析及Bonferroni事后检验，以评估术后各时间点的动态变化以及SAS的效果（α=.05）。
结果： 本研究纳入4名受试者（17枚种植体，7枚种植体颊侧放置8个缝线锚定）。平均KMW从0.14 mm（T0）显著增加至5.40 mm（T1）、4.82 mm（T2）和4.07 mm（T3）（与T0相比P<.05），T3时收缩率为24.28%。VD从0 mm（T0）增加至8.03 mm（T1）和8.40 mm（T2）（与理想值6 mm相比P<.05），T2时退缩率为18.30%。在T3时，锚定部位显示出显著较少的KMW收缩（P=.021）和VD退缩（P<.001），优于非锚定部位。VAS评估显示，受试者在KMA当天感到轻度疼痛，此后无明显疼痛。
结论： IISP-MCSS+SAS有助于重建颌骨种植体周围角化组织增量，促进形成牢固附着的角化黏膜和稳定的前庭深度。
英文摘要
STATEMENT OF PROBLEM: Poor peri-implant soft tissue conditions in the reconstructed jaw pose challenges to long-term implant success rates. Although several peri-implant soft tissue management techniques in reconstructed jaws have been described, studies evaluating their postoperative effectiveness are lacking.
PURPOSE: This prospective single cohort study aimed to optimize peri-implant keratinized mucosa augmentation (KMA) in the reconstructed jaw by using a custom set of interim implant-supported prosthesis and mucocompressive surgical stent (IISP-MCSS) combined with suture-anchor system (SAS) during secondary surgery and to evaluate its clinical effectiveness.
MATERIAL AND METHODS: Four patients with mandibular reconstruction using free fibular flaps (FFF) received IISP-MCSS+SAS-assisted KMA surgery. This included an apically positioned flap or vestibuloplasty (APF/V) and a free epithelial masticatory mucosal graft (FEG). Keratinized mucosa width (KMW) and vestibular depth (VD) were recorded pre-KMA (T0), immediately post-KMA (T1), 4 weeks (T2), and 12 weeks (T3). Postoperative pain was evaluated with a visual analog scale (VAS). The KMW shrinkage rate and VD increase or recession rate were calculated and statistically analyzed using paired t tests, and a 2-way repeated measures ANOVA with Bonferroni post hoc tests was performed to evaluate the dynamic postoperative changes across time points and the effect of SAS (α=.05).
RESULTS: This study involved 4 participants (17 implants, 8 suture-anchors on the buccal side of 7 implants). Mean KMW significantly increased from 0.14 mm (T0) to 5.40 mm (T1), 4.82 mm (T2), and 4.07 mm (T3) (P<.05 compared to T0), 24.28% shrinkage (T3). VD increased from 0 mm (T0) to 8.03 mm (T1) and 8.40 mm (T2) (P<.05 compared to the ideal 6 mm), with a recession rate of 18.30% at T2. Anchored sites showed significantly less KMW shrinkage (P=.021) and VD recession than non-anchored sites (P<.001) at T3. VAS evaluation showed that participants felt mild pain on the day of KMA, with no significant pain thereafter.
CONCLUSIONS: IISP-MCSS+SAS assisted in peri-implant keratinized tissue augmentation in the reconstructed jaw, contributing to the formation of firmly attached keratinized mucosa and stable vestibular depth.