The 'Iceberg' Connective Tissue Graft Technique for Peri-implant Papilla Augmentation Following Interproximal Bone Reconstruction.

IF 1.3 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Istvan A Urban, Leonardo Mancini, Hom-Lay Wang, Lorenzo Tavelli
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Abstract

Implants with deficient papillae and black triangles are common findings. The treatment of these esthetic complications is considered to be challenging with limited predictability. Therefore, the present report aims to describe a novel technique for papilla augmentation: the 'iceberg' connective tissue graft (iCTG) after extraction and interproximal bone reconstruction in the anterior region. A 35-year-old patient presented with a hopeless tooth with interproximal clinical attachment loss extending to the apical third of the adjacent tooth. Interproximal bone reconstruction was performed through alveolar ridge preservation by directly applying recombinant human platelet-derived growth factor-BB (rhPDGF-BB) to the exposed root surface of the adjacent tooth. A mixture of autogenous bone chips (obtained from the ramus) and bovine bone xenograft particles (previously mixed with the growth factor) was also used. The patient was able to return for implant therapy only 2 years later, at which time an incomplete regeneration of the interproximal bone was observed. Therefore, to compensate the interproximal deficiency, the iCTG approach was utilized, involving a double layer of CTG with different origins. Two small grafts from the tuberosity were sutured to the mesial and distal ends of a wider CTG harvested from the palate, aiming to gain additional volume at the interproximal sites. The composite graft was then sutured on top of the implant platform, and the flap was then released and closed by primary intention. After conditioning the peri-implant tissues, the case was finalized with a satisfactory outcome. The described iCTG could be an effective approach for reconstructing peri-implant papillae following interproximal bone reconstruction.

冰山 "结缔组织移植技术用于近端骨重建后的种植体周围乳头增生。
种植体乳头缺损和黑三角是常见的结果。这些美学并发症的治疗被认为具有挑战性,而且可预测性有限。因此,本报告旨在描述一种在前牙区域拔牙和近端骨重建后进行乳头增量的新技术(冰山结缔组织移植法[iCTG])。一名 35 岁的患者因一颗无望的牙齿而就诊,其近端临床附着丧失一直延伸到相邻牙齿根尖的三分之一处。在邻牙暴露的牙根表面直接应用重组人血小板衍生生长因子-BB(rhPDGF-BB),通过牙槽嵴保留进行近端骨重建。此外,还使用了先前与生长因子混合的自体骨片(取自颌骨)和牛骨异种移植颗粒的混合物。患者两年后才再次接受种植治疗。观察到近端骨间的再生不完全。因此,为了弥补近端骨间的缺损,采用了 iCTG 方法,包括不同来源的双层 CTG。将来自结节的两块小移植物缝合到从腭部获取的较宽 CTG 的中端和远端,以增加近端间的骨量。然后,将复合移植物缝合到种植体平台的顶部,并释放皮瓣,按原意关闭。在对种植体周围组织进行调理后,该病例最终获得了令人满意的结果。所描述的 iCTG 可以作为近端骨重建后重建种植体周围乳头的有效方法。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
113
审稿时长
6-12 weeks
期刊介绍: The International Journal of Periodontics & Restorative Dentistry will publish manuscripts concerned with all aspects of clinical periodontology, restorative dentistry, and implantology. This includes pertinent research as well as clinical methodology (their interdependence and relationship should be addressed where applicable); proceedings of relevant symposia or conferences; and quality review papers. Original manuscripts are considered for publication on the condition that they have not been published or submitted for publication elsewhere.
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