数字化辅助美学区穿埋伏牙即刻种植一例

A case of digitally assisted immediate implant placement through impacted teeth in the aesthetic area

本文介绍一例数字化辅助美学区穿埋伏牙即刻种植的病例。患者因上前牙外伤致根折,来诊发现患牙根方骨内存在1颗阻生尖牙和2颗埋伏多生牙。治疗中在数字化外科导板引导及Er:YAG激光辅助下,实现穿埋伏牙即刻种植,同期自体牙骨移植材料与富血小板纤维蛋白混合行双区骨增量。一期手术后5个月和8个月分别利用数字化技术完成临时修复和永久修复。术后CBCT示种植体分别穿埋伏牙冠部及根尖部牙骨质、牙本质及牙髓。复诊随访未见疼痛及其他任何并发症。18个月复诊无任何临床症状,CBCT影像示种植体周围骨密度增高,骨白线已形成。本病例在数字化辅助下实现了美学区穿埋伏牙即刻种植,为埋伏牙治疗方案的选择提供了新的临床思路,为种植体除骨结合外其他愈合形式增添了临床数据,但此类术式的临床效果仍需长期随访观察。

This paper presents a case of digitally assisted immediate implantation through impacted teeth in the aesthetic area.The patient had a root fracture caused by an upper anterior teeth trauma.One impacted canine and two impacted supernumerary teeth were found in the bone on the root side of the affected teeth.During treatment,under the guidance of the digital surgical guide plate and assistance by Er:YAG laser,immediate implantation through the impacted teeth was achieved.At the same time,autologous bone grafting material and platelet-rich fibrin were mixed for bone grafting at the two implant sites.Provisional and permanent restorations were completed with digital technology at 5 months and 8 months after the first stage of surgery,respectively.Postoperative CBCT showed that the implants penetrated through the crown,apical cementum,dentin,and pulp of the impacted teeth.No pain or other complications were found during the follow-up visit.There were no clinical symptoms at the 18-month follow-up visit.CBCT images showed that the bone density around the implants had increased and the lamina dura had formed.In this case,immediate implantation through the impacted teeth in the aesthetic area was realized with the digital assistance,providing a new clinical idea for the selection of treatment options for impacted teeth and increased clinical data for other healing forms of implants besides osseointegration.However,the clinical effect of this kind of operation still needs long-term follow-up observation.