上颌前牙区即刻种植修复软组织改变的临床研究

Clinical study on soft tissue alterations of immediate implant placement and restoration in upper anterior teeth

目的:观察即刻种植修复在上颌前牙区牙龈组织萎缩高度及患者自主满意程度,探讨提高前牙美容效果的临床技巧。方法:15例前牙缺失患者在不翻瓣拔牙的条件下同期植入ITI种植体18枚,48小时内完成上部临时固定修复,种植体植入后3个月进行永久修复。测量术后1月,3月,6月,12月牙龈萎缩高度及永久修复后患者主观满意程度。结果:18枚种植体均形成良好的骨结合,无炎症发生。1月后牙龈平均萎缩高度为(0.31±0.28)mm,3月为(0.60±0.44)mm,6月为(0.28±0.32)mm,12月为(0.32±0.60)mm。患者主观满意程度达8.8分。结论:三维位置正确的种植体可获得良好的美学效果和长期稳定性,在严格把握适应症的前提下,上前牙即刻种植修复可获得理想的临床效果。

Objective： The aim of the prospective study was to evaluate the soft tissue changes of upper ante-rior teeth, the patients＇ satisfaction on aesthetic effectiveness and the clinical skills to improve the ef-fect of anterior area aesthetic outcome. Methods： 18 implants were inserted immediately with flapless approach in upper anterior teeth of 16 patients, 48 hours to finish the provisional restoration, and the fi-nal restorations were finished in 3 months after implant operation. To evaluate the soft tissue changes measurements were repeated at 1, 3, 6, and 12 months and the patients＇ satisfaction on aesthetic effec-tiveness after final restorations. Results： 18 implants integrated and none had any biological compli-cations. A mean recession of the buccal margin of （0.31±0.28） mm was recorded at 1 month（0.60±0.44） mm was recorded at 3 months, （0.28±0.32） mm was recorded at 6 months, （0.32±0.60） mm recorded at 12 months. the score of the patients＇ satisfaction was 8.8 points. Concluusion： the good aesthetic out-come and long-term stability seem to validate the trimodal approach protocol. After a careful and strict selection of patients, immediate implant restoration can obtain ideal clinical effect.