改良式引导骨再生术+即刻修复技术在上前牙即刻种植中的应用评价

The evaluation of applying modified guided bone regeneration and immediate restoration technique in the immediate implant in maxillary anterior teeth

目的评估一种改良式引导骨再生术（guided bone regeneration，GBR）＋即刻修复技术在上前牙即刻种植中的应用效果，特别是美学效果，并探讨其临床技巧及美学影响因素。方法选择15例单颗上前牙进行即刻种植，微创拔牙后即刻植入Replace、Straumann或Ankylos种植体共15枚，采用改良式GBR十即刻修复，均于2h内完成临时修复。4～6个月后完成最终修复。种植修复完成后随访6～24个月，观察种植体周围软硬组织情况，统计种植义齿存留率、种植修复体与相邻天然牙唇侧牙龈的协调性和患者主观满意度。结果在观察期内，15枚种植体均获得了良好的骨结合，无松动，未见病理性骨吸收，存留率为100％；12枚种植修复体唇侧龈缘位置与邻牙协调无差异，3枚轻度差异；14枚种植修复体与邻牙牙龈颜色质地协调无差异，1枚轻度差异。患者主观满意度VAS平均值为92。结论改良式GBR＋即刻修复技术在上前牙即刻种植中，有助于获得理想的前牙美学效果，缩短治疗周期。

Objective To evaluate the effects,especially the esthetic effect of applying modified GBR and immediate restoration in the immediate implant in maxillary anterior teeth as well as the technique skills and influence factors. Methods 15 cases of hopeless anterior single tooth were included in this study. Replace, Straumann or Ankylos implantswere implanted after atraumatic tooth removal. Provisional restoration was completed with modified GBR and immediate restoration technique in 2 hours. The final restorations were made after 4-6 months. The follow-up period is 6-24 months. The survival rate,the coordination of soft tissue with neighboring tissue and the satisfactory level of patients were evaluated. Results In the 6 and 12 months follow-up period,all 15 implants have successful ossteointegration without any failure. The survival rate is 100%. 12 implants had perfect soft tissue compared with neighboring tooth, while 3 had slight difference in terms of margin position. 14 implants had perfect soft tissue compared with neighboring tooth,while 1 had slight difference in terms of color and texture. The mean satisfactory level of patients in terms of VAS was 92. Conclusions The modified GBR and immediate restoration technique in immediate implant is helpful to get ideal esthetic result and to reduce the treat-ment span.