微创拔牙即刻种植的牙龈美学效果观察  

Minimally invasive extraction and immediate implant placement with single-stage surgical procedure:a clinical observation of 21 cases

作　　者：邱立新[1] 林野[1] 李健慧[1] 邸萍[1] 崔宏燕[1] 王涛[1] 

机构地区：[1]北京大学口腔医学院.口腔医院口腔种植中心,100081

出　　处：《中华口腔医学杂志》2007年第11期647-650,共4页Chinese Journal of Stomatology

摘　　要：目的探讨微创拔牙即刻种植技术的临床特点及修复后的牙龈美学效果。方法 21例上前牙单个缺失病例,行不翻瓣微创拔牙同期23颗种植体即刻植入,并且同期安装愈合基台直接暴露于口腔,即非埋入式种植术式,种植体愈合6个月后进行永久修复。种植永久修复后观察时间平均27.6个月(13～51个月)。根据 Jemt 牙龈乳头指数(papilla index score,PIS)观察种植体永久修复12个月后的近远中牙龈乳头状况,根据 Fürhauser 的改良红色美学指数观察种植体永久修复1年后与相邻天然牙唇侧龈缘位置的协调性;唇侧软组织与相邻天然牙唇侧牙龈色泽协调性。结果 23颗种植体均获得良好的骨结合;种植修复体近远中 PIS 均为Ⅱ级以上。种植修复体与相邻天然牙唇侧牙龈缘水平位置协调性一致的15颗,8颗不协调;唇侧软组织色泽与相邻天然牙协调一致的18个牙位,5个牙位有轻度差异。结论微创拔牙即刻种植术是一项要求较高的技术,多因素影响软组织美学效果,严格掌控适应证,才能获得理想修复效果。Objective To evaluate the clinical results of minimally invasive extraction without flap reflection and immediate implant placement with single-stage surgical procedure. Methods Twenty-one patients （ 23 single-tooth implants） were included in the study. Eight fractured teeth and 15 residual roots in the maxillary anterior region were extracted without flap reflection and implants placed immediately. Special gingival former was connected at the same time of implant placement with single-stage surgical procedure, final prostheses were restored after 6 months. The follow-up time was from 13 months to 51 months（ mean： 27.6 months ） after final restoratio. Clinical and radiographic study were conducted, the interproximal papillae were analyzed according to Jemt＇s classification and the level of soft-tissue margin and buccal soft tissue color were evaluated according to Ftirhauser＇ s method. Results All 23 implants acquired osseointegration, and the level of marginal bone at the mesial and distal aspects of all implants were stable. The mesial and distal papilla index score of 3 were observed in 18 implant sites, the papilla index score of 2 in 5 implant sites. Harmonious relationship of gingival margin between peri-implant restorations and adjacent natural teeth was observed in 15 implant sites. The color of buccal soft tissue matched that of the adjacent natural teeth in 18 implant sites, 5 sites showed minor discrepancies. All the patients were satisfied with the final restoration. Conclusions Minimally invasive extraction without flap reflection and immediate implant placement with single-stage surgical procedure is a sensitive technique. Many factors may affect the final results and the strict control of indication is the key factor.

关 键 词：拔牙 牙种植体 单牙 牙乳头 即刻种植 

分 类 号：R783.6[医药卫生—口腔医学]