美学区分阶段骨增量联合邻牙显微根尖手术的 治疗策略:临床诊治流程及实践病例

Therapeutic strategy of staged bone augmentation in the esthetic zone combined with microsurgical apical surgery on adjacent teeth:clinical diagnosis and treatment process and case study

前牙美学区种植手术中,通常需要结合不同的骨增量手术,来实现理想的前牙骨弓轮廓和软组织的协调。然而,种植位点邻牙的慢性根尖周围炎症可能成为潜在的感染源,这可能导致早期的骨增量失败,或者进一步影响种植体的根部引发逆行性种植体周炎。本文详细阐述了1例前牙美学区骨缺损伴邻牙根尖周病变的典型病例,通过使用牙本质壳技术与显微根尖手术相结合的方式进行分阶段骨增量并完成种植修复,避免种植相关骨增量手术中开辟第二术区取骨的创伤,为口腔内存在阻生齿等无功能天然牙的骨缺损修复治疗病例提供了一种微创治疗的选择,同时在种植手术过程中消除邻牙潜在的感染源,从而保证了口腔治疗远期效果的可预测性。

In implant surgery in the esthetic zone of anterior teeth,different degrees of bone augmentation are often necessary to achieve an ideal anterior dental arch contour and soft tissue harmony.However,chronic periapical inflammation of adjacent teeth at the implant site may become a potential source of infection,leading to early failure of bone augmentation or further affecting the root of the implant,potentially resulting in retrograde peri-implantitis.This report presents a typical case involving an anterior dental bone defect with periapical lesions of adjacent teeth.Staged bone augmentation and implant restoration were performed by combining the dentin shell technique with microsurgical apical surgery.This approach avoided the trauma of harvesting autologous bone from a second surgical site during bone augmentation,offering a minimally invasive option for bone defects involving non-functional natural teeth,such as impacted teeth.Additionally,the potential source of infection from adjacent teeth was addressed during implant surgery,ensuring the long-term predictability of the treatment outcome.