CHANGES IN GUM BIOTYPE IN THE PROJECTION OF DENTAL IMPLANTS

Abstract

Deficiency of keratinized gum in the peri-implant zone contributes to bone recession and visualization of implant necks and abutments through its thin layer. To develop clinically effective and scientifically based protocols for the prevention and treatment of pathology of tissues surrounding implants, it is necessary to study the risk factors for the occurrence of mucositis and peri-implantitis, one of which is the deficiency or complete absence of attached keratinized gum in the implant area, as a result of which the mobile mucous membrane is constantly displaced during eating, talking, performing hygiene procedures. The gums are easily injured, which leads to rapid colonization of pathogenic microflora and the development of initial inflammation in the form of mucositis. The inflammatory process is launched, which in turn leads to an increase in the activity of osteoclasts. It should be noted that the rate of development of the inflammatory process in the area of implants is much higher than in the area of teeth. Due to the absence of the periodontal ligament, the inflammatory infiltrate directly spreads to the alveolar bone and penetrates into the medullary spaces. The gum contour in the area of installed implants must be aesthetic, stable and dense. This together will not only provide a cosmetic effect, but will also prevent the development of early and late complications of dental implantation. The paper provides an analysis of various methods of mucogingival surgery in the field of dental implants using an allogeneic graft of the “Alloplant” series. Engraftment of mucosal autografts from the tubercle of the upper jaw after surgery is accompanied by severe inflammation, which can lead to scarring of the mucosa or exposure of the bone. Allografts transplanted to patients to thicken the gums in the area of implantation are completely replaced after 6 months without signs of rejection or inflammatory processes by a full-fledged connective tissue regenerate covered with stratified squamous keratinizing epithelium. In the surgical area, gum tissue is formed in thickness, which can be classified as a “thick” gum phenotype.