上前牙美学区即刻种植的研究现状

在牙齿拔除的同时将种植体立即植入新鲜拔牙窝的种植方式,其具有减少手术次数和整体治疗时间、充分利用现有骨量、具有理想的美学效果等优点。然而,即刻种植同样存在本身固有的缺点,由于拔牙窝的存在,创口的关闭较困难;由于种植体的尺寸与拔牙窝不匹配,较难达到良好的初期稳定性;并且存在软组织退缩的风险。本文就上前牙美学区即刻种植的成功率、适应证及其扩展、手术要求、并发症及其防治等方面作一综述。文献复习结果表明,即刻种植的5年成功率高于95%。其适应证包括:拔牙窝完整;唇侧骨壁厚度至少为1mm;厚龈生物型;种植位点无急性感染;根尖区足够骨量以提供良好初期稳定性。同时近年来随着种植外科技术的改良和骨替代材料性能的改善,即刻种植已成为口腔种植诊疗中的常规手段之一,并且其适应证有进一步扩大趋势。但其也有并发症,包括种植体植入位置不佳,牙龈退缩造成美学效果欠佳。此外即刻种植即刻修复和常规负荷表现出相似的结果,并有利于获得更好的美学效果,但关于即刻种植软组织美学的长期稳定性和患者满意度尚需进一步研究。

Current status of immediate implant placement in the aesthetic zone of the anterior teeth

The method of placing an implant immediately into the fresh extraction socket at the same time as tooth extraction has the advantages of reducing the number of operations and the overall treatment time,making full use of the existing bone mass,and resulting in ideal aesthetic effects.However,immediate implant placement also has its own inherent shortcomings.Due to the existence of the extraction socket,it is difficult to close the wound;because the size of the implant does not match the size of the extraction socket,it is difficult to achieve good initial stability,and there is a risk of soft tissue recession.This article reviews the success rate,indications and expansion of immediate implant placement,surgical requirements,complications and the prevention and treatment of anterior teeth in the aesthetic area.A literature review showed that the 5 year success rate of immediate implant placement was over 95%.The indications included intact socket walls,a facial bone wall at least 1 mm in thickness,the presence of thick,soft tissue,the absence of acute infection at the site,and the availability of bone apically and lingually to the socket to provide primary stability.In addition,in recent years,with the improvement of surgical implantation technology and the improvement of bone sub stitute material performance,immediate implant placement can be used as one of the conventional methods for oral im plantation treatment,and its indications have shown a trend toward expansion.Immediate implant placement also has complications,including poor placement of implants and gingival receding that results in poor aesthetic outcomes.In addition,immediate restoration and conventional loading protocols after immediate implant appear to have similar out comes and result in better aesthetic effects.However,the long term stability and patient satisfaction after immediate im plant placement in terms of soft tissue aesthetics require more research.