上颌中切牙微创拔牙即刻种植联合牙龈诱导的美学效果

Aesthetic Effect of Minimally Invasive Extraction and Immediate Implant Placement Combined with Inducing Gingival Formation for Maxillary Central Incisors

目的:观察并探讨上颌中切牙微创拔牙即刻种植联合牙龈诱导的美学效果。方法:选择2014年5月~2016年12月就诊的上颌中切牙因疾患无法保留的患者共16例,共18颗上颌中切牙,均采取微创拔除后即刻植入,2.5~3个月行种植体支持临时义齿牙龈诱导成形术,6个月进行永久冠修复。采用牙槽骨吸收水平、红色美学评分、患者满意率来对种植美学效果进行评价。结果:18枚种植体均获得良好的骨结合,修复后6个月种植体唇侧骨板厚度(2.13±0.78)mm,近中侧骨吸收量为(0.21±0.54)mm,远中侧骨吸收量为(0.24±0.41)mm;PES为(7.78±1.11),与拔牙前无显著性差异。患者美观满意度平均为97.5%。结论:上颌中切牙微创拔牙后即刻种植联合牙龈诱导的修复美学效果良好,微创拔牙、种植体唇侧骨板的厚度、近远中骨量保存和永久修复前牙龈诱导是成功的关键。

Objective： To investigate aesthetic effect of minimally invasive extraction and immediate implant place- ment combined with inducing gingival formation for maxillary central incisors. Methods： 16 patients with hopeless maxillary central incisors were enrolled in the research form May 2014 to Dec 2016. The 18 maxillary central incisors were extracted without flap reflection and 18 implants were replaced immediately. Gingival contour was induced u- sing implant--supported temporary crowns from 2.5 months to 3 months after implantation. Permanent prostheses were delivered 6 months later. The peri--implant bone level, the pink esthetic score and subjective satisfaction were evaluated 6 months after the permanent restoration. Results： 18 implants osseointegrated successfully. The labial bone thickness was（2.13±0.78）mm, while mesial and distal marginal bone resorption were （0.21±0.54） mm and （0.24±50.41） mm. PES was （7. 78±1. 11） after loading for 6 months. The patient＇s satisfaction was 97. 5%. Conclusion.. Minimally invasive extraction and immediate implant placement combined with inducing gingival forma- tion for maxillary central incisors achieves great aesthetic effects. The keys to success are minimally invasive extrac- tion, labial bone thickness, mesial and distal marginal bone reservation and inducing gingival formation.