口腔种植修复应用的根膜技术

Application of the socket-shield technique in the implant restoration

背景:根膜技术可有效维持即刻种植位点良好的软硬组织形态,在美学区的种植修复中具有非常好的临床应用前景。目的:综述根膜技术在种植修复中的研究进展及应用。方法:运用计算机检索PubMed数据库、Web of Science数据库、万方数据库、CNKI中国期刊全文数据库中2000年1月至2021年1月收录的相关文献。英文检索词为“immediate implant,socket-shield technique,root-membrane technique,root-implant”,中文检索词为“即刻种植,根膜技术,牙片屏障技术,牙根屏障技术,盾构术,牙根盾技术”。通过阅读文题和摘要进行初步筛选,排除相关性低及重复文章,最终纳入58篇文献进行综述分析。结果与结论:根膜技术是一种新的牙槽嵴保存技术,与传统方法相比可有效维持即刻种植位点的软硬组织形态,且针对不同临床情况可选择性保留牙槽窝内不同位置的根片,该技术在前牙美学区的种植修复中具有良好的应用前景。然而根膜技术敏感性较强,临床操作中保留根片的厚度、高度及长度对最终修复效果均有所影响。此外,根膜技术与传统种植相比可能出现根片暴露、根片吸收等生物并发症,因此在尚无更丰富的组织学证据和长期随访数据前,根膜技术在常规临床实践中应谨慎使用。

BACKGROUND:The socket-shield technique can effectively maintain good soft and hard tissue morphology of the immediate planting sites and has a considerable application prospect in the esthetic zone.OBJECTIVE:To review the research progress and application of socket-shield technique in implant restoration.METHODS:Compute rs were used to retrieve the PubMed,Web of Science,Wanfang and CNKI databases for relevant lite rature published from January 2000 to January 2021.The Chinese and English key words were "immediate implant,socket-shield technique,root-membrane technique,root-implant". Through reading the titles and abstra cts,the articles with low correlation and duplication were screened out,and 58 articles were finally included for review and analysis.RESULTS AND CONCLUSION:The socket-shield technique is a new method of alveolar ridge preservation,which can effectively maintain the hard and soft tissue morphology of the immediate implant site compared with the traditional method and selectively retain the root slices at different positions in the alveolar fossa according to different clinical conditions.Therefore,it has a considerable application prospect in the implant and restoration of the aesthetic area of ante rior teeth.However,the socket-shield technique is sensitive,and the thickness,height and length of the retained root laminae in clinical operation all have an influence on the final resto ration effect.In addition,compared with traditional planting,socket-shield technique may have biological complications such as root exposure and root absorption.Thus,it should be used with caution in routine clinical practice until more abundant histological evidence and longterm follow-up data are available.