“盾构术”的临床应用及潜在风险

上前牙拔除后唇侧牙槽骨迅速发生吸收,不仅降低上前牙区种植修复的美学效果,骨量不足也会影响种植体的长期成功率。近年来国内外报道“盾构术”在上前牙区应用实现了牙槽嵴轮廓的保持,成为一个新的美学区种植的治疗方案。但也有部分文献指出“盾构术”或其相关改良术式出现一些近远期并发症:如局部炎症、牙槽骨吸收、骨结合失败等。本文对“盾构术”相关文献进行综述,研究表明“盾构术”虽然在不少个案中获得良好的临床效果及短期成功率,但由于该技术缺乏长期及大量临床文献支持,在实际操作过程中存在许多不统一的意见,如牙片的厚度、牙片在牙槽骨内深度、牙片与植体间是否需要植骨等,操作具有技术敏感性,因此在临床应用中应谨慎采用该项技术,减少无法预料的风险。

Application of the socket shield technique and its potential risks

The rapid absorption of labial alveolar bone after tooth extraction not only reduces the aesthetic effect of implant repair but also affects the long?term success rate of implants.The socket shield technique is reported as the lat?est alveolar preservation technique in the aesthetic zone from both domestic and international case reports and shows a high success rate of short?term osseointegration and excellent aesthetic effects.However,some investigations have shown short?and long?term complications with the socket shield technique,such as failure of osseointegration,loss of crestal bone and buccal bone,inflammation,etc.In this review,the socket shield technique will be reported in detail with its pros and cons.Although the socket shield technique has achieved good clinical effects and short?term success rates in many cases,there are still no conclusions regarding the surgical procedure,such as the thickness,the position of the shield,whether to put the graft material between the shield and implant,etc.Due to the lack of long?term re?search or a large amount of clinical literature support and technical sensitivity,the socket shield technique should be carefully used in clinical application to reduce unexpected risks.