上颌前牙即刻种植即刻修复的临床应用研究

Clinical application of immediate implant placement and immediate restoration in upper anterior teeth

目的:评估上颌前牙区即刻种植即刻修复的临床应用效果,特别是美学效果,并探讨其临床应用技巧及美学影响因素。方法:选择16例共18颗无法保存的上前牙,微创拔除后即刻植入Xi ve或Repl ace种植体共18枚,均于48小时内完成临时固定修复,4～6个月后完成最终修复。种植永久修复后追踪观察12～36个月,观察种植体周围软硬组织情况,统计种植义齿存留率、牙龈乳头充盈指数以及修复体与相邻天然牙唇侧牙龈的协调性、患者主观满意度。结果:在观察期内18枚种植体均获得了良好的骨结合,种植体无松动,种植体周围未见病理性骨吸收,存留率为100%;18枚种植修复体周围共34个牙龈乳头充盈指数均为2到3度,其中24个(70.6%)为3度;15枚种植修复体唇侧龈缘位置与相邻天然牙协调无差异,3枚轻度差异;16枚种植修复体与相邻天然牙牙龈颜色质地协调无差异,2枚轻度差异。患者主观满意度VAS值平均达91.5。结论:在严格掌握适应证的前提下,应用正确的手术技巧对无法保存的上前牙进行微创拔除后即刻种植即刻修复能获得理想的临床效果,特别是美学效果。

Objective:To evaluate the clinical effect and clinical procedures of immediate implant placement and immediate restoration in upper anterior teeth.Methods:18 Xive/Replace implants were inserted immediately after minimally invasive extraction in upper anterior teeth of 16 patients.The provisional fixed restorations were fabricated within 48 hours and the final restorations were finished in 4-6 months.The tracking survey was taken from 12 to 36 months after restoration.The situation of soft and hard tissue,implant retention rate,papilla index score(PIS),harmonious relationship of gingival margin between the implant restoration and the nature teeth,and patient satisfaction were evaluated.Results:All of the 18 implants achieved osseointegration.No implant looseness or bone resorption was observed.The survival rate of the implants was 100%.The PIS of 34 sites around 18 implant was 2 or 3,while the PIS of 3 was observed in 24 sites(70.6%).Harmonious relationship of gingival margin between the implant restoration and the nature teeth was observed in 15 implant sites,3 sites showed minor discrepancies.The color and texture of gingiva around 16 implant sites showed no obvious differences from the adjacent natural teeth,2 sites showed minor discrepancies.The patient satisfaction VAS score in average reached 91.5.Conclusion:Based on the strict control of indication,immediate implant placement and immediate restoration after minimally invasive extraction in upper anterior teeth can achieve good clinical effect especially esthetic effect.