种植暂时修复体在上颌前牙种植美学修复中软组织处理技术

目的:种植美学修复中对于种植体周围软组织的精确塑形并将最终塑形好的软组织轮廓精确的转移到模型上,这一中间环节对种植的最终美学修复效果至关重要。本研究目的旨在探讨种植美学修复中应用种植暂时修复体对种植体周围软组织进行诱导塑形的技术要点及其临床效果。方法:2005年10月至2009年2月共57例连续在北京大学口腔医院种植科就诊的上颌前牙缺失患者纳入本研究,所有患者均采用种植暂时修复体对种植体周围软组织进行诱导塑形,并对最终种植修复体进行修复效果的美学评估。美学评价指标包括牙龈乳头水平及种植体唇侧软组织丰满度。结果:57例患者共植入73枚种植体,平均追踪时间32.7个月(24-64个月),至最后一次复查未见种植体脱落。57例中单牙缺失43例,相邻2个牙位缺失7例,多牙缺失7例。修复后6个月与修复后2年相比牙间乳头由I度变为I I度2个牙位;牙龈唇侧丰满度由I I度变为I度2个牙位,I度变为0度4个牙位,但无统计学差异(P>0.05)。结论:尽最大可能保存软硬组织的形态结构并重建与重塑软组织是治疗过程中需要考虑的主要因素。而修复过程中应用种植暂时修复体对种植体周围软组织进行诱导塑形,精确确定基台及上部结构的的形态与大小,将对最终美学修复效果起到至关重要的影响。

peri-implant soft tissue special management using implant-supported provisional prostheses in maxillary esthetic zone

Objective:Obtaining an accurate representation of the soft tissue contours developed around an implant in the esthetic zone is crucial to the success of a restoration.The aim of this study is to evaluate the periimplant soft tissue esthetics and special technical management in the maxillary esthetic zones.Methods:From October 2005 to February 2009 57 patients were enrolled in this study consecutively in Department of Implant Dentistry,Peking University,School & Hospital of Stomatology and underwent the periimplant soft tissue management using the present technique.Esthetic evaluations included papilla index and the labial peri-implant soft tissue fullness.Results:Totally 73 implants were placed in 57 cases.The mean follow-up was 32.7 months and no implant was lost until the last recall.Among the 57 patients 43 were single tooth missing,7 lost 2 teeth,as well 7 lost more than 3 teeth.Papilla evaluation showed that Degree I changed to Degree II in 2 tooth sites,as well peri-implant gingival fullness evaluation showed that Degree II changed to Degree I in 2 tooth sites and Degree 0 to Degree I in 4.However,no statistical significance was observed(P>0.05).Conclusion:Preservation of as much of both the hard and soft tissue architecture as possible and methods to reconstruct and modify it are major considerations during treatment.Precise size and shape of the transmucocal prosthetic abutments and framework after induced by implant-supported provisional prostheses is important to achieve an esthetic result.