Figen ÖNGÖZ DEDE, Selman ÇELEN, Şeyma BOZKURT DOĞAN, Varol ÇANAKÇI

PERİ-İMPLANT DEFEKTİN TEDAVİSİNDE ALTERNATİF BİR METOD OLARAK BUKKAL YAĞ DOKUNUN KULLANIMI: BİR OLGU RAPORU

Giriş: Peri-implant defektler, dental implant yerleştirilmesinden sonra protetik yükleme yapılmadan hastaya veya cerrahi uygulamalara bağlı nedenlerle oluşabilmektedir. Son zamanlarda bukkal yağ dokunun fibröz iyileşme potansiyeli nedeniyle peri-implant defektlerin iyileştirilmesine katkıda bulunduğu ve tatmin edici klinik ataçman seviyesi sağladığı belirtilmiştir. Bu olgu raporunda peri-implant defektin, otojen kemik grefti ve membran olarak bukkal yağ dokusu ile yapılan tedavisi gösterilmektedir. Olgu raporu: 60 yaşındaki erkek hastanın sol alt çene birinci molar bölgesine yerleştirilen implant etrafında klinik ve radyografik muayene esnasında alveoler kemik kaybı ve dişeti inflamasyon varlığı tespit edildi. Öncelikle lokal anestezi altında flep kaldırıldıktan sonra titanyum küretlerle implant çevresindeki granülasyon dokuları uzaklaştırıldı ve %3’lük H2O2 ile implant yüzeyine muamele yapıldı. İmplant etrafındaki defekt otojen kemik grefti ile dolduruldu ve üzeri bukkal yağ dokudan elde edilen serbest bukkal yağ grefti ile kapatıldı. 2 yıllık takip dönemi boyunca klinik ve radyografik olarak implant ve etrafındaki periodontal dokuların sağlıklı bir şekilde korundukları gözlendi. Sonuç: Bukkal yağ dokusu, implant etrafındaki defekte doldurulan kemik greft partiküllerini koruyarak yumuşak dokuya kolayca adapte olmuştur. Ancak bukkal yağ dokusunun, peri-implant defektlerin tedavisinde etkisinin değerlendirilebilmesi için in-vivo çalışmalarla desteklenmesine ihtiyaç vardır. Anahtar Kelimeler: Peri-implant defekt, bukkal yağ dokusu, yumuşak doku grefti THE USE OF THE BUCCAL FAT PAD AS AN ALTERNATİVE METHOD TO REPAİR PERİ-İMPLANT DEFECT: A CASE REPORT ABSTRACT Aim: Peri-implant defects may occur due to reasons related to the patient or surgical applications without prosthetic loading after dental implant placement. Recently, it has been reported that buccal fat pad contributes to the improvement of peri-implant defect because of the potential of fibrous healing and provides satisfactory clinical attachment level. In this case report, treatment of peri-implant defect with an autogenous bone graft and buccal fat pad as a barrier membrane is presented. Case Report: A 60-year-old male patient was determined to have alveolar bone loss and gingival inflammation during clinical and radiographic examination around the implant placed in the first molar region of the left mandible. The periodontal flap was removed under local anesthesia, then the granulation tissue around the implant was removed with titanium curettes and the implant surface was treated with 3% H2O2. The defect around the implant was filled with autogenous bone graft and covered with free buccal fat graft from the buccal fat pad. Regarding the clinical and radiological examination, it was observed that the implant and surrounding periodontal tissues were maintained healthy during 2-year follow-up period. Conclusions: Buccal fat pad, improves the protection of the bone graft particles and is also easily adaptable to soft tissue. However, there is a need to be supported by in-vivo studies to evaluate the effect of the use of buccal fat pad for treatment of peri-implant defects. Key Words: Peri-implant defect, buccal fat pad, soft tissue graft

Anahtar Kelimeler:

Peri-implant defekt, bukkal yağ dokusu

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