KERATİNİZE MUKOZANIN İMPLANTLARIN UZUN DÖNEM BAŞARISINDAKİ ÖNEMİ VE PALATİNAL ROTASYONEL SAPLI FLEP UYGULAMASI: OLGU SUNUMU

OZET Diseti sagligini korunmasi ve periodontal hastaliklarin ilerlemesinin onlenmesi adina belirli miktarda keratinize disetinin gerekli oldugu dusunulmektedir. Restorasyon sinirlarinin subgingival alana uzandigi dislerde keratinize mukoza bandinin ince olmasi diseti iltihabi gelisme riskinin yuksek olmasi ile iliskilidir. Ayrica dental implantlarin uzun donem basarisi kacinilmaz bir sekilde; implant cevresi dokularda enfeksiyon gelisiminin engellenmesine ve/veya travmaya bagli implant kayiplarinin onune gecilmesine baglidir. Bu olgu sunumunda dental implant yerlestirilmesi sonrasi yetersiz keratinize mukoza bandi varligi saptanan hastanin Palatinal Rotasyonel Sapli Flep (PRSF) teknigi ile tedavisi aciklanmistir. Posterior maksilla bolgesine yerlestirilen iki implantin iyilesme donemlerinde bukkal yuzeylerindeki alveol mukozada hareketlilik gozlenmistir. Diseti sekillendiricilerin koyulmasinin ardindan implant cevresindeki hareketli yumusak doku PRSF teknigi ile duzeltilmistir. Uc hafta sonunda implantlarin bukkal boyun bolgelerinde yaklasik 3 mm keratinize mukoza elde edilmistir. Sonuc olarak uzun donem implant stabilitesi ve implant cevresi dokularin sagliginin korunmasi keratinize mukoza miktari ile direk iliskilidir. Tum cerrahi islemler implant uygulamasi veya protetik yukleme gerceklestirilmeden once yapilmalidir. Anahtar kelimeler: Keratinize mukoza, dental implant, diseti sagligi THE IMPORTANCE OF KERATINIZED MUCOSA IN LONG TERM MAINTENANCE OF DENTAL IMPLANTS AND PALATINAL ROTATIONAL PEDICULATED FLAP APPLICATION: CASE REPORT ABSTRACT The presence of adequate zone of keratinized gingiva is thought to be necessary for the maintenance of gingival health and prevention of periodontal disease progression. In teeth with subgingival restorations, narrow zone of keratinized mucosa is associated with higher chance of gingival inflammation. Also, prevention of periimplant tissue infection and/or traumatic loss are inevitable for the long term success of dental implants. This case report describes the rehabilitation of the inadequate keratinized mucosa band determined after dental implants placement, by using Palatinal Rotational Pediculated Flep technique (PRPF). Mobile alveolar mucosa at the buccal side of two implants which were placed at posterior maxilla was observed in the healing period. Mobile mucosa that surrounds periimplant area was managed with PRPF technique after placement of gingiva formers. The keratinized mucosa has been obtained approximately 3 mm at buccal cervical region of implants after three weeks. In conclusion, the long term stability and maintenance of dental implants are directly related to amount of keratinized mucosa at periimplant area. All surgical interventions would rather be carried out before the implant placement or the prosthetic loading. Key words: Keratinized mucosa, dental implant, gingival health