前牙区软硬组织增量相关并发症及临床处理策略

Complications of soft and hard tissue augmentation in anterior teetharea and clinicalmanagement strategies

上前牙区为美学关键区,历来都是种植修复的难点和热点,但因各种牙周和根尖周问题导致的拔牙,常使种植修复面临牙槽嵴水平向及垂直向骨量不足的困境。前牙区牙槽嵴骨增量的手术方法包括引导骨组织再生术、块骨移植术、骨劈开骨挤压术等,而即使采取骨增量手术后仍存在一定数量的病例出现软组织塌陷,为此临床上常采用游离结缔组织移植的方法来恢复美学区的软组织轮廓。由此而来,伴随各种复杂的软硬组织手术,不可避免地会出现一系列并发症,包括创口裂开、感染、出血、血肿,神经损伤,移植物暴露、坏死、吸收,软组织开裂,角化龈宽度、厚度不足等。文章针对上颌前牙区骨增量和软组织增量相关并发症及临床处理策略逐一介绍,并提出风险防控建议,以期降低相关术式并发症的发生率。

Implant restoration in the maxillary anterior region is a challenging task as it is the most critical area for aesthetics in the mouth.However,tooth extraction due to various periodontal and apical problems often leads to insufficient horizontal and vertical bone masses in the alveolar cleft during implant restoration.The surgical procedures for bone augmentation in the anterior alveolar crest region include guided bone tissue regeneration,block bone transfer,and bone splitting and condensing.However,soft tissue collapse can still occur even after bone augmentation surgery.To restore the soft tissue contours of the esthetic zone,free connective tissue transfer is often used clinically.These complex soft and hard tissue surgeries can cause complications such as wound dehiscence,infection,bleeding and hematoma,nerve injuries,implant exposure,necrosis and absorption,soft tissue cracking,and insufficient width or thickness of keratinized gingiva.This study introduces the risk factors and clinical management strategies of complications related to bone augmentation and soft tissue augmentation in the maxillary anterior zone,and presents some risk prevention and control suggestions in order to reduce the incidence of complications.