窄直径种植体穿龈式种植术在小间隙前牙早期美学修复应用

Clinic experience of performing minimally-invasive flapless trans-gingiva approaching technique on narrow clearance frontal teeth with narrow-diameter implant and early esthetic restoration

目的:评估窄直径种植体穿龈式种植术在小间隙前牙早期美学修复的美观性和患者满意程度。方法:采用穿龈式种植术在23例前牙小间隙缺失区植入共23枚窄直径种植体,术后1月内行冠修复。以红美学(pink esthetic score,PES)及白美学(white esthetic score,WES)进行美学评估,ISQ值评估1个月后行冠修复时,植体与骨结合情况,以视觉模拟评分法(visua1 analogue scale,VAS)测量患者主观满意度。结果:术后1个月行冠修复时ISQ值(65.24±1.34),种植体具有良好的稳定性,适合行冠修复。患者PES值在随访3个月与1个月相比有增加趋势(P<0.05),6个月与3个月相比PES略微增加,但无统计学意义。WES值偏高,有约87%分布在高分区。VAS在3个月随访与1个月相比有增加趋势(P<0.05),6个月与3个月相比VAS略微增加,但无统计学意义。结论:穿龈式种植术配合窄直径种植体行早期美学修复的方式在前牙小间隙缺牙区可得到良好的美观性,患者满意度佳。

Objective： To analyze the minimally-invasive surgery with flapless trans-gingiva approaching technique on narrow clearance frontal teeth,and the placement of narrow-diameter implant and early crown restoration according to esthetic outcome and patient satisfaction after treatment. Methods： Twenty-three patients（ 23 implants in total） receiving flapless tans-gingiva implant surgery with the placing of narrow-diameter implant（ NDI） and early loading after 1 month are selected. Pink esthetic score（ PES） and white esthetic score（ WES） were used to evaluate esthetic degrees,that PES was estimated and recorded at 1-month,3-month and 6-month follow-up,whereas WES was evaluated and recorded right after permanent restoration. Patient satisfaction degree were measured by visual analogue scale（ VAS） at 1-month,3-moth and 6-month follow-up. Results： PES was higher in 3-month follow-up（ P 〈 0. 05）,compared with PES in 1-month follow-up. There was no significant difference between 3-month and 6-month follow-up. There were about 87% of WES categorized in high score region. VAS was higher in 3-month follow-up（ P 〈 0. 05）,compared with VAS in 1-month follow-up,and there was no significant difference between 3-month and 6-month follow-up. Conclusion： Trans-gingiva approaching technique cause minimal damage to gingiva,and usually results in less post-surgery pain and high patient satisfaction. Using the technique along with narrow-diameter implant and early crown restoration is a safe and predictable option.