Title POSTUPCI AUGMENTACIJE MEKIH TKIVA U PODRUČJU MUKOGINGIVNIH DEFEKATA
Title (english) SOFT TISSUE AUGMENTATION PORCEDURES FOR MUCOGINGIVAL DEFECTS
Author Patricia Deša
Mentor Jelena Prpić (mentor)
Committee member Jelena Prpić (predsjednik povjerenstva)
Committee member Davor Kuiš (član povjerenstva)
Committee member Tomislav Ćabov (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Oral Medicine and Periodontology) Rijeka
Defense date and country 2018-06-27, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Dental Medicine Periodontology
Abstract Mukogingivni defekti najčešće su posljedica parodontne ili periimplantatne bolesti i/ili gubitka zuba. Posljedično dolazi do gubitka alveolarne kosti koji je praćen smanjenjem volumena pripadajućeg mekog tkiva: gingive, periimplantatne mukoze i/ili sluznice alveolarnog grebena.
Koštani defekti uz zub mogu biti jednozidni, dvozidni ili trozidni. Najčešći defekti mekog tkiva uz zube su gingivne recesije. Upravljanje mekim tkivom oko implantata uključuje tehnike za povećanje širine prićvrsne gingive, povećanje volumena mekog tkiva oko implantata. Defekti alveolarnog grebena nastaju kao posljedica parodontne bolesti, traume ili traumatske ekstrakcije. Klasifikacija resorbiranog grebena temelji se na procjeni gubitka vertikalne i horizontalne dimenzije.
Materijali koji se koriste za augmentaciju mekog tkiva su SGT, PE - SGT, SVT, peteljkasti vezivni transplantat, PRF i ksenogeni kolageni tkivni matriks. Vrlo često se u praksi kombiniraju mekotkivni transplantati s koštanim transplantatima. Transplantati se najčešće uzimaju sa nepca. Zlatni standard je SVT. Osnovna razlika SGT-a i SVT-a je u tome što SGT sadrži i epitelno tkivo što je zbog narušene estetike najveći nedostatak ovog transplantata. Peteljkasti vezivni transplantat je vrsta SVT-a čija je prednost dobra vaskularna opskrba.
Defekti uz zub, ovisno o klasi po Milleru se u pravilu tretiraju mekotkivnim transplantatima, a najuspješnija tehnika je SVT prekriven koronalno pomaknutim režnjem.
Defekt uz implantat do 2 mm augmentira se sa SVT-om uz koronalno pomaknuti režanj. Ukoliko je defekt izraženiji preporuka je augmentirati koštanim nadomjesnim materijalom.
Augmentirati se može meko i/ili tvrdo tkivo bezubog grebena. Tehnike augmentacije mekog tkiva su „kotrljajući“ postupak, SVT i onlay transplantati, dok se za augmentaciju koštanog tkiva najčešće koriste koštani nadomjesci i membrane.
Abstract (english) Mucogingival defects are most frequently consequences of periodontal or peri-implant disease and/or tooth loss. The end result is the loss of alveolar bone accompanied by a decrease in volume of the soft tissue: gum, peri-implant mucosa and/or mucosa of the alveolar ridge.
Bone defect adjacent to the tooth can be classified as a one-, two- or three- wall defect. The most common defects of the soft tissue are gingival recessions. Soft tissue manipulation around implants includes techniques for the increase of the width of the attached gingiva, and techniques for the increase of the soft tissue volume around the implant. Defects of the alveolar ridge occur as a consequence of the periodontal disease, trauma or traumatic extraction. The classification of the resorbed ridge is based on the estimate of the vertical and horizontal reduction in ridge dimensions.
Materials used for soft tissue augmentation provedures are free gingival graft, partially epithelialized free gingival graft, connective tissue graft, pedicular connective tissue graft, PRF and xenogenic collagen tissue matrix. The combinations of soft tissue grafts with bone grafts are very frequent in clinical practice. Grafts are usually harvested from the palate. Golden standard is the CTG. The basic difference between FGG and CTG is that FGG includes the epithelium which due to inferior aesthetics results presents the major defect of this graft. Pedicular connective tissue graft is a type of CTG whose advantage is a good vascular supply.
Defects adjacent to the tooth, depending on the Miller classification, are regularly treated with soft tissue grafts, and the most successful technique is CTG covered by coronally advanced flap.
Defects adjacent to the implants measuring up to 2 mm are augmented with CTG + CAF. If defects are greater, it is recommended to augment with bone grafts.
Soft and/or hard tissue of edentulous ridge may also be augmented. Procedures used to augment soft tissue are the roll technique, CTG and onlay grafts. Finally, to augment bone tissue, the most commonly used technique is bone grafts with membranes.
Keywords
augmentacija
defekti
graft
meko tkivo
parodont
Keywords (english)
augmentation
defects
grafts
periodontal
soft tissue.
Language croatian
URN:NBN urn:nbn:hr:184:837163
Study programme Title: Dental Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
Type of resource Text
File origin Born digital
Access conditions Access restricted to students and staff of home institution
Terms of use
Created on 2018-10-09 09:27:55