牙根屏障技术的临床应用与评估

Clinical application and evaluation of socket shield technique

目的评估牙根屏障技术的临床应用效果和相关技术参数。方法回顾性分析2015年2月至2019年12月完成的18例(21个种植位点)采用牙根屏障技术进行种植修复的病例,其中11例(14个种植位点)来自四川大学华西口腔医院种植科,7例(7个种植位点)来自重庆医科大学附属口腔医院种植科;男性10例,女性8例,年龄(41.2±10.8)岁。分析患者牙根片厚度及高度与唇颊侧牙槽骨改建的关系,进行粉白美学指数评分,并分析并发症,提出预防措施。结果牙根片高度、厚度与唇颊侧牙槽骨垂直向改建均呈负相关关系(r=-0.458,P=0.037;r=-0.574,P=0.007),牙根片厚度与牙槽骨水平向改建呈负相关关系(r=-0.619,P=0.003)。3例患者(3个种植位点)出现根片内暴露,没有种植体失败。18例患者均获得较好的粉白美学效果。结论进行严格的病例筛选及精细的手术操作,并确保牙根片有足够的厚度,牙根屏障技术可获得较好的种植修复美学效果。

Objective To further improve socket shield technique.The treatment outcome and the key related factors in Asian population are evaluated by measuring the root fragment and alveolar crest parameters in immediate implant placement cases with socket shield.Methods A total of 18 patients,with 21 implants placed using socket shield technique were included in this retrospective study.Fourteen implants of 11 cases were recruited from West China Hospital of Stomatology,Sichuan University,7 implants of 7 cases were recruited from Stomatological Hospital of Chongqing Medical University.The relationship between the thickness of the root fragment,the vertical height of the root fragment and the dimensional changes of buccal alveolar bone in 6 months was analyzed respectively.The pink-white esthetic scores were evaluated.The complications were recorded,analyzed and preventive measures were put forward.Results There is a negative correlation between the vertical height of tooth fragment and the buccal crest height reduction(r=-0.458,P=0.037).There were negative correlations between the thickness of the tooth fragment with the vertical dimensional changes(r=-0.574,P=0.007)and horizontal dimensional changes(r=-0.619,P=0.003)of buccal alveolar bone.Three cases with internal exposure were recorded during the treatment.No severe complications were observed.Every case achieved a satisfying pink-white esthetic outcome according to the existing treatment protocols.Conclusions Rigorous case screening,delicate surgical procedures,and maintaining adequate thickness of the root are the key to achieve a good esthetic outcome of implant treatment with socket shield technique.