摘要
目的:即刻种植被广泛认为是可靠而成功率相当高的治疗方法。主要的优点是:1、缩短疗程;2、保存牙槽骨;3、易于确定种植体位置。拔牙后3-12个月牙槽骨吸收程度最明显。拔牙后即刻种植被认为是保留牙槽骨的最好方法,但是有学者认为拔牙植骨后延迟种植对于美学效果更加可靠。我们总结了上颌前牙区即刻种植和延迟种植的两组病例,对其牙槽骨的变化和软组织变化进行追踪和测量。材料方法:组一:即刻种植拔牙前拍摄,不翻瓣拔牙后行即刻种植,种植系统为NobelBiocare Replace或Ankylos。在种植体骨壁之间填塞Bio-Oss骨颗粒和Bio-Gide胶原膜。仔细关闭伤口,以确保初期愈合。术后6个月拍3D锥形束CT,并开始修复(临时或者永久修复)。组二:延迟种植拔牙同时植入Bio-col骨胶原,3个月后行种植体植入,之后6个月开始临时修复。种植体植入后6个月拍摄3D锥形束CT。结果:通过3DCT观察,两组患者的牙槽骨都得到了比较好的保存,牙龈的边缘水平和牙龈乳头的高度都比较理想。第二组患者在拔牙后和种植后牙龈乳头变圆钝,有不同程度的萎缩现象,但是在临时修复后3个月出现自动恢复的现象。结论:两组患者都显示出美学效果良好,说明这两种方法都可以比较可靠地达到良好的美学效果。即刻种植更显示出缩短疗程的优势;而延迟种植需要更长的治疗时间。我们建议在前牙即刻种植或延迟种植时使用引导骨再生技术,同时使用移植骨材料和隔离膜。在组织稳定性和美学效果的稳定性方面还需要长期的前瞻性临床观察。
Immediate placement of implants has been found to have a high rate of success.The main advantages are： 1／shorter time of treatment;2／conservation of the crest bone;3／exact positioning of the implant.It was shown that major changes in an extraction site occur in the first 3 months after tooth extraction especially the buccal bone and the interdental crest.While many researchers believe that delayed implant placement for anterior teeth is more predictable for the esthetic result.This study is to observe the clinical result of immediate implant and delayed implant,and also measure the volume through 3D-CT.Group 1： Immediate implant 9 Patients presented untreatable anterior upper teeth.Cone Beam CT were took before surgeries.Teeth were extracted without flap reflection,and implants （Nobel Biocare Replace/Ankylos） were inserted simultaneously.Bio-Oss granules and Bio-Gide membrane were used to fill the gap between the implant and the bone wall.Mattress suture was adopt on both sides of the healing abutment to achieve the primary wound closure.Cone beam CT was took after 6 months from the day of implants placement.Group 2：Delayed implant 5 patients presented two untreatable anterior upper teeth.We follow the delayed implant protocol.Teeth were extracted with bone（Bio-Oss/Bio-col）graft.Implants（Nobel Biocare Replace/Ankylos） were placed following two stage protocol with guided bone regeneration （Bio-Oss granule and Bio-Gide mambrane） after 3 months.6 months after the implant placement,healing abutments were placed.Cone bean CT was took after 6 months from the day of implants placement.Result： Through the comparison of the 3D-CT pre-op and post-op,the alveolar bone was preserved very well on both groups.The gingival margin level and the papilla are quite favorable on both groups.On the second group,during the early months after teeth extraction,the papilla showed different level absorption,while recovered spontaneously after delivered provisional crowns.Conclusion： Both two cases got optim
出处
《中国口腔种植学杂志》
2011年第1期67-68,共2页
Chinese Journal of Oral Implantology
