上颌切牙不翻瓣即刻种植的临床效果

Clinical effects of flapless immediate implantation of maxilla incisor

目的评估上颌切牙单牙不翻瓣即刻种植对牙槽骨和牙龈附着的影响。方法选择15例上颌前牙区因外伤、残根或根折等需拔除患牙行即刻种植修复的患者,共15颗切牙,术前行X线曲面断层片及牙科CT检查,评估牙槽骨高度、厚度与牙龈附着情况,微创拔除患牙后作植入前评估,采用不翻瓣即刻种植方法植入Anky-los种植体15颗,骨缺隙部分填充骨粉,穿龈愈合。术后5个月复诊行上部结构修复,对比术前与修复后的牙槽骨与牙龈退缩情况。结果 15颗种植体成功完成上部结构修复。修复时和术前比较,牙槽骨吸收(1.10±0.26)mm,牙龈退缩(0.81±0.31)mm,牙龈乳头形态保存良好。结论上颌切牙位点使用不翻瓣即刻种植,能有效保护种植区牙槽嵴,从而防止牙龈出现明显退缩,有利于维持种植区的美学效果。

Objective To evaluate the effects of maxilla incisor flapless immediate implantation on the alveolar bone absorption and gingival attachment.Methods Choose 15 patients requesting immediate implant on the upper anterior area,duo to trauma,residual root or fracture.X-ray and CT examinations were taken to estimate the height,thickness of the bone and relative conditions of the teeth.After the pre-operation evaluation after minimized invasive teeth extraction,15 Ankylos implants were inserted using flapless immediate implantation technique.The transgingival healing was applied,and bone defects were filled with bone substitute,and then the conditions of alveolar bone and gingival were recorded.Restoration was finished 5 months later,both bone absorption and gingival recession were compared between those of before and after operation.Results None of the 15 implants failed,with a final successful restoration and a good shape of gingival papilla,average bone absorption and gingival recession were respectively（1.10±0.26） mm and（0.81±0.31） mm.Conclusion Flapless immediate implantation at the incisor sites can preserve alveolar ridges at target area,and avoid obvious gingival recession and finally maintain aesthetics effect.