Inserción tisular supracrestal (espacio biológico) en la práctica clínica: una revisión narrativa
DOI:
https://doi.org/10.15517/5v9wzx95Palabras clave:
Periodonto; Encía; Enfermedades gingivales; Cirugía periodontal; Tecnología dental.Resumen
La inserción tisular supracrestal, conocida históricamente como ancho biológico, constituye una unidad dentogingival fundamental para la salud periodontal y la predictibilidad restauradora. Esta revisión narrativa evalúa las estrategias convencionales y asistidas por tecnología para su preservación. Se realizaron búsquedas en PubMed/MEDLINE, Scopus y Web of Science. Los estudios elegibles incluyeron revisiones sistemáticas y narrativas, documentos de consenso, ensayos clínicos, estudios comparativos y series de casos. La evidencia fue evaluada críticamente utilizando el marco del Oxford Centre for Evidence-Based Medicine (OCEBM) y se sintetizó temáticamente en tablas comparativas y de recomendaciones. Las técnicas convencionales (gingivectomía, colgajos de acceso, osteotomía y osteoplastia) siguen siendo confiables cuando se aplican bajo principios biológicos y protésicos. Los procedimientos asistidos con láser optimizan el manejo de los tejidos blandos al mejorar la precisión, lograr una hemostasia efectiva y reducir la morbilidad. Los flujos de trabajo digitalmente guiados que integran CBCT, escaneo intraoral y tecnología CAD/CAM permiten un mapeo preciso y reproducible, especialmente en casos con altas exigencias estéticas. El manejo óptimo requiere una planificación individualizada que combine enfoques convencionales, asistidos por láser y digitales dentro de un marco basado en la evidencia, garantizando así estabilidad periodontal, longevidad restauradora y resultados estéticos armónicos en la práctica clínica.
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Derechos de autor 2026 César-Augusto Padilla-Avalos, Consuelo Marroquín-Soto, Gianella Sedano Huaman, Paula Ximena Gómez Restrepo, Rocío Alvarez Medina, Claudio Peña-Soto.
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