Periodontal Fenotip ve Klinik Önemi
Özet
Periodontal fenotip, diş hekimliğinde estetik ve cerrahi tedavilerin başarısını ve prognozunu doğrudan etkileyen, diş eti kalınlığı, keratinize doku genişliği ve bukkal alveoler kemik kalınlığının kombinasyonundan oluşan bir yapıdır. Literatürde yakın zamana kadar biyotip ve fenotip terimleri karmaşık şekilde kullanılmış olsa da, 2017 Dünya Çalıştayı çevresel faktörlerle değiştirilebilen bu dinamik yapıyı tanımlamak için "periodontal fenotip" terimini önermiştir. Diş eti fenotipi genel olarak ince-skallop, kalın-skallop ve kalın-yassı olmak üzere üç grupta sınıflandırılmakta; ince fenotipe sahip bireylerde diş eti çekilmesi, periodontal hastalık ilerlemesi ve cerrahi komplikasyon riski daha yüksek seyretmektedir. Yapışık keratinize doku genişliğinin doku sağlığını korumak için en az 2 mm olması önerilirken, sert ve yumuşak doku kalınlıklarının ortodontik, protetik ve implant tedavileri öncesinde konik ışınlı bilgisayarlı tomografi gibi yöntemlerle üç boyutlu değerlendirilmesi klinik olarak büyük önem taşımaktadır.
Periodontal phenotype is a structure consisting of the combination of gingival thickness, width of keratinized tissue, and buccal alveolar bone thickness, which directly affects the success and prognosis of aesthetic and surgical treatments in dentistry. Although the terms biotype and phenotype had been used confusingly in the literature until recently, the 2017 World Workshop recommended the adoption of the term "periodontal phenotype" to describe this dynamic structure that can be modified by environmental factors. Gingival phenotype is generally classified into three groups as thin-scalloped, thick-scalloped, and thick-flat; individuals with a thin phenotype exhibit a higher risk of gingival recession, progression of periodontal disease, and surgical complications. While a width of attached keratinized tissue of at least 2 mm is recommended to maintain tissue health, three-dimensional evaluation of hard and soft tissue thicknesses using methods such as cone-beam computed tomography prior to orthodontic, prosthetic, and implant treatments is of great clinical importance.
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