前颌原位离体牙冠在即刻种植修复时的应用  

The use of in situ autogenous tooth of the crown on the anterior maxilla-mandible to solve immediate implant restoration

作　　者：吴大怡[1] 腾立钊[1] 张沃淮[1] 

机构地区：[1]卫生部口腔种植科技中心

出　　处：《中国口腔种植学杂志》2009年第2期29-30,共2页Chinese Journal of Oral Implantology

摘　　要：目的:利用原位自体牙的全冠或牙面解决上下颌前牙即刻种植同期修复时暂冠的自然美学问题。方法:1、病例选择,经临床确诊符合拔除并且满足即刻种植条件的上下前颌牙各10例,其临床牙冠完整或牙冠唇侧面基本无缺损,需要同期实现种植义齿过渡性临时全冠修复的病例。2、离体牙的处理及临时冠制备,包括消毒处理,将拔出牙清洗后立即浸泡于10%的甲醛液处理10分钟;牙冠或牙面修形,根据即刻种植义齿临床牙冠的预计高度,横切离体牙,修磨预留用牙冠部分。离体牙冠修形处理的三种情况:①牙冠形态结构基本完好,则用金刚砂石钻针修磨去除牙冠内部大部分牙本质,形成一个中央空心的"壳冠",被修磨牙冠的内部空间形态与调磨就位的种植体基台外观形态接近;②牙冠小部分缺损、唇侧面完整,则修磨缺损区域,去除病理性结构玻璃离子光固化树脂修补,再按"壳冠"预备方式修磨处理;③牙冠舌侧大部分缺损、唇侧面基本完整,则保留唇侧牙面,磨除其余结构,与自凝树脂联合应用形成"壳冠"。3、受植床与种植体基台预备参照拟选种植体系统的种植外科操作步骤,预备种植体受植床并置放种植体,按照永久性修复体设计与佩戴方式,采用直接或间接法修磨种植体基台的外观形态,供种植义齿暂时性牙冠修复使用。4、临时冠试戴将制备好的自体牙"壳冠"戴入种植体基台,调整咬合后暂时粘固。结果:实施病例共计15例,即刻种植修复义齿15枚,均获得预期效果,患者满意。全部病例在种植术6个月以后更换为金瓷或全瓷冠修复。结论:利用被拔出自体牙的冠部或牙面进行原位即刻种植义齿过渡期的修复,能够完整地表现种植牙的自然性和真实性。Purpose:The use of in situ autogenous tooth or tooth surface of the crown on the maxilla or mandibular anterior teeth to solve immediate implant restoration the same period in the interim crown when the issue of natural aesthetics.Method:1、Consistent with the clinical diagnosis and to meet the immediate removal of the upper and lower pre-planting conditions for the 10 cases of jaw teeth,the clinical crown or crown lip complete the basic non-defect side,the realization of the need for the same period of transitional implant crown the whole case.2、In vitro treatment of tooth preparation and provisional crown。Antisepsis,Will be pulled out immediately after cleaning teeth soaking in 10% formaldehyde solution for 10 minutes to deal with;Crown or the tooth surface modification,in accordance with immediate implant clinical crown height of the expected,in vitro cross-cutting teeth grinding with crowns set aside part of。Crown modification in vitro of three deal with the situation:①Intact crown morphology,Diamond burs with grinding stone to remove the majority of crowns within dentin,forming a central hollow 'shell crown',the repair of molar crown shape and tune the internal space of the implant in place mill base close to the appearance of the form;②small portion of defects in crown、complete Labial side,Grinding defect region,Removal of pathological structure light-cured glass ionomer resin patch,and then 'shell crown' grinding to prepare the way to deal with;③Lingual crown most defects,the basic integrity of the side lip,the labial tooth surface to retain,in addition to the remaining mill structure,and self-curing resin to form a joint application 'shell crown.' 3、By the bed and the implant abutment preparation.Implant system with reference to the cultivation of selected steps,by the implant bed preparation and implant placement,in accordance with the permanent prosthesis design and to wear the way of direct or indirect method of grinding the appearance of implant abutment form for temporary the use of

关 键 词：即刻种植 牙面 前颌 修形 即刻种植义齿 牙冠 离体牙 

分 类 号：R783.6[医药卫生—口腔医学]