Soft tissues around the dental implants folowing mandibular segmental defect replacement: quantity and quality comparison assessment.

Abstract

Objective: Aim: To compare the quantity and quality of surrounding soft tissues in patients after segmental mandibular defect reconstruction (SMDR) with bone grafts, before and after placement of implant-supported dental prostheses (ISDPs).

Patients and methods: Materials and Methods: A total of 74 patients were included and divided into main (MG) and control (CG) groups. The MG consisted of patients after SMDR. The CG comprised 49 patients with a Kennedy Class II dental arch defect following tooth extraction. The width and area of attached gingiva (AG) were assessed before and after ISDP placement using intraoral scanning.

Results: Results: After ISDP placement, the mean buccal width of AG at the medial implant was 0.94±0.90 mm in the MG and 2.18±0.95 mm in the CG (p<0.01). In the distal buccal region, the median values were 0 (IQR: 0-1) mm and 1.7 (IQR: 1-6) mm, respectively (p<0.001). The mean lingual width at the medial implant was 1.11±0.99 mm in the MG and 2.24±0.97 mm in the CG, whereas at the distal implant the median values were 0 (IQR: 0-0.6) mm and 2.1 (IQR: 1.5-2.75) mm, respectively (p<0.001). The median area of AG was 63.3 (IQR: 38.9-100.45) mm² in the MG and 233.9 (IQR: 186.75-295.75) mm² in the CG (p<0.001).

Conclusion: Conclusions: Patients after SMDR and placement of ISDP are characterized by lower quality and reduced volume of AG compared to conventionally rehabilitated patients with ISDP. To improve the long-term prognosis of treatment, soft tissue augmentation may be recommended.