J Periodontal Implant Sci.  2016 Oct;46(5):329-336. 10.5051/jpis.2016.46.5.329.

Preservation of keratinized mucosa around implants using a prefabricated implant-retained stent: a case-control study

• Kim CS
• Duong HP
• Park JC
• Shin HS

• KMID: 2354931
• DOI: http://doi.org/10.5051/jpis.2016.46.5.329

Abstract

PURPOSE
The aim of this study was to clinically assess the impact of a prefabricated implant-retained stent clipped over healing abutments on the preservation of keratinized mucosa around implants after implant surgery, and to compare it with horizontal external mattress sutures.
METHODS
A total of 50 patients were enrolled in this study. In the test group, a prefabricated implant-retained stent was clipped on the healing abutment after implant surgery to replace the keratinized tissue bucco-apically. In the control group, horizontal external mattress sutures were applied instead of using a stent. After the surgical procedure, the width of the buccal keratinized mucosa was measured at the mesial, middle, and distal aspects of the healing abutment. The change in the width of the buccal keratinized mucosa was assessed at 1 and 3 months.
RESULTS
Healing was uneventful in both groups. The difference of width between baseline and 1 month was −0.26±0.85 mm in the test group, without any statistical significance (P=0.137). Meanwhile, the corresponding difference in the control group was −0.74±0.73 mm and it showed statistical significance (P<0.001). The difference of width between baseline and 3 months was −0.57±0.97 mm in the test group and −0.86±0.71 mm in the control group. These reductions were statistically significant (P<0.05); however, there was no difference between the 2 groups.
CONCLUSIONS
Using a prefabricated implant-retained stent was shown to be effective in the preservation of the keratinized mucosa around implants and it was simple and straightforward in comparison to the horizontal external mattress suture technique.

Keyword

Dental implants; Gingiva; Stents; Suture techniques

MeSH Terms

Case-Control Studies*
Dental Implants
Gingiva
Humans
Mucous Membrane*
Stents*
Suture Techniques
Sutures
Dental Implants

Figure

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  Figure 1 Clinical photo of a prefabricated implant-retained stent.

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  Figure 2 Clinical photograph of #37 implant first-stage surgery, which was adopted with the horizontal external mattress suture technique (control group). (A) The flap was secured using horizontal external mattress sutures and vertical pressure was applied over the flaps. (B) Ten days post-operation. (C) Three months post-operation. The healing was uneventful and the width of keratinized mucosa was well preserved.

• 

  Figure 3 Clinical photograph of #35 implant first-stage surgery using a prefabricated implant-retained stent (test group). (A) The flap was placed bucco-apically using the stent. Dead space could be eliminated by vertical pressure from the stent. (B) Ten days post-operation. (C) Three months post-operation. Soft tissue healing is uneventful and the width of keratinized mucosa was well preserved.

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  Figure 4 Schematic illustration showing the 2 different approaches. (A) Following the lingualized incision, the keratinized tissue was mobilized bucco-apically, and the prefabricated implant retained stent was applied to the healing abutment (test group). The flap is pressed down and displaced to preserve the keratinized tissue. (B) The external mattress suture is applied and the displaced flap is pushed down and apically (control group). However, there is limitation in the displacement in comparison to that of using the stent.

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