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中华口腔医学研究杂志(电子版) ›› 2009, Vol. 3 ›› Issue (04) : 435 -442. doi: 10.3877 / cma.j.issn.1674-1366.2009-04-015

临床研究

单个上前牙即刻种植即刻非功能修复的临床疗效观察
罗智斌1,(), 曾融生1, 罗志宾1,(), 林丽婷1, 徐佳丽1   
  1. 1.510055 广州,中山大学光华口腔医学院·附属口腔医院·口腔医学研究所
  • 收稿日期:2009-03-14 出版日期:2009-08-01
  • 通信作者: 罗智斌, 罗志宾

The clinic effect of immediate single-tooth implants and non-functional provisional crowns in the anterior maxilla

Zhi-bin LUO1,(), Rong-sheng ZENG1, Zhi-bin LUO1,(), Li-ting LIN1, Jiali XU1   

  1. 1.Guanghua School of Stomatology, Institute of Stomatological Research, Sun Yat-sen University,Guangzhou 510055, China
  • Received:2009-03-14 Published:2009-08-01
  • Corresponding author: Zhi-bin LUO, Zhi-bin LUO
引用本文:

罗智斌, 曾融生, 罗志宾, 林丽婷, 徐佳丽. 单个上前牙即刻种植即刻非功能修复的临床疗效观察[J/OL]. 中华口腔医学研究杂志(电子版), 2009, 3(04): 435-442.

Zhi-bin LUO, Rong-sheng ZENG, Zhi-bin LUO, Li-ting LIN, Jiali XU. The clinic effect of immediate single-tooth implants and non-functional provisional crowns in the anterior maxilla[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2009, 3(04): 435-442.

目的

探讨美学区单个上前牙即刻种植即刻非功能修复临床疗效。

方法

7 例上颌单个无法保留患牙,拔除后即刻植入种植体,当日制作并戴入临时树脂冠,6 个月后复诊取模,选择合适基台制作永久金属烤瓷或全瓷修复体,最终修复体戴入后1 年复诊,比较刚戴入修复体与1 年后随诊时种植体周骨组织水平以及红色美学指数(PES)的变化情况。

结果

种植体成功率为100%,种植体近、远中周牙槽骨变化分别为(0.79 ± 0.48)mm、(0.71± 0.46)mm;刚戴入修复体与1 年后随诊时PES 值分别为(8.6 ± 1.3)和(11.1 ± 1.8),Walcoxon统计学分析,两者差异有统计学意义(P=0.027)。

结论

在严格选择病例的情况下,单牙即刻种植即刻非功能修复,可取得很好的美学效果,种植体周软组织美学效果随着戴入时间增长可得到改善,是一种可行的方法。

Objective

To observe the clinical effect of the restoration of a single upper missing tooth with immediate implant placement and non-functional prosthesis in the aesthetic area.

Methods

Seven consecutive patients with un-savable single teeth in the aesthetic zone were included. Teeth were extracted and replaced with immediate implant and non-functional provisional crowns. Suitable permanent abutments were chosen and porcelain-fused-metal or allceramic restorations were made on the abutments after 6 months. Patients were followed up 1 year after crown insertion. The marginal bone level around the implant and Pink Esthetic Score (PES)value immediately after crown insertion and 1 year later were measured for comparison.

Results

The success rate of implant was 100%, mesial and distal peri-implant bone changes were (0.79 ±0.48)mm and (0.71 ± 0.46)mm respectively. The average PES value was (8.6 ± 1.3) and (11.1± 1.8), respectively. Significant difference was found by Walcoxon analysis (P =0.027).

Conclusions

For strictly selected cases, single-tooth immediate implant and immediate nonfunctional prosthetsis is an effective method. Good appearance can be achieved and the esthetics of peri-implant soft tissue can be improved over time.

图1 21 外伤后根折, 无法保留
图2 术前X 片示根折线
图3 微创拔除患牙,保持骨壁的完整性
图4 拔牙后制备种植窝, 植入Replace 种植体5 mm × 13 mm, 确保种植体的三维方向准确,种植体与拔牙窝间隙用自体骨泥填塞, 植入扭矩大于等于35N/cm
图5 手术当天戴入临时义齿,临时义齿由颈部折断的自然牙冠修改制作
图6 6 个月后制作永久修复体Al2O3 全瓷冠,PES 值为7
表1 即刻种植即刻修复牙位及种植体情况
表2 近远中种植体周骨组织水平变化
表3 患者永久牙冠戴入以及1 年后复诊软组织红色美学指数
图7 1 年后随诊见唇侧龈缘轻度退缩,牙龈乳头充盈邻间隙,PES 值为9.5
图8 刚戴入Al2O3 全瓷冠后的X 线示种植体骨整合界面形成
图9 种植修复体完成功能性负载1 年后种植体周牙槽骨平均吸收量近中为0.35 mm,远中为0.24 mm
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