磨牙位点保存后进行种植修复及软组织增量的1例报告  

Dental implantation and soft tissue augmentation after ridge preservation in a molar site:a case report

作　　者：赵丽萍[1] 詹雅琳 胡文杰[1] 王浩杰[1] 危伊萍 甄敏[1] 徐涛[1] 刘云松[2] ZHAO Li-ping ZHAN Ya-lin HU Wen-jie WANG Hao-jie WEI Yi-ping ZHEN Min Xu Tao LIU Yun-song(Department of Periodontology Department of Prosthodontics, Peking University School and Hospital of Stomatology ＆ National Engineering Laboratory for Digital and Material Technology of Stomatology ＆ Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China)

机构地区：[1]北京大学口腔医学院·口腔医院牙周科,北京100081 [2]北京大学口腔医学院·口腔医院修复科,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京100081

出　　处：《北京大学学报（医学版）》2016年第6期1090-1094,共5页Journal of Peking University:Health Sciences

基　　金：首都医学发展科研专项基金(2011-4025-04);教育部留学回国人员科研启动基金(2012-45)资助~~

摘　　要：临床上,常规拔牙后牙槽骨的自然愈合存在不同程度的牙槽骨吸收,影响未来的种植体植入修复位置,角度及软、硬组织处理。研究表明,采取微创拔牙和位点保存技术可以减少牙槽骨吸收,显著保留牙槽嵴宽度及高度,减少或避免种植治疗同期实施复杂的植骨手术。另有文献指出,种植体周围至少需要2 mm的角化龈及1 mm的附着龈,方能维护种植体周围组织健康,获得长期稳定疗效。For ideal implant rehabilitation,an adequate bone volume,optical implant position,and stable and healthy soft tissue are required. The reduction of alveolar bone and changes in its morphology subsequent to tooth extraction will result in insufficient amount of bone and adversely affect the ability to optimally place dental implants in edentulous sites. Preservation of alveolar bone volume through ridge preservation has been demonstrated to reduce the vertical and horizontal contraction of the alveolar bone crest after tooth extraction and reduce the need for additional bone augmentation procedures during implant placement. In this case,a patient presented with a mandible molar of severe periodontal disease,the tooth was removed as atraumatically as possible and the graft material of Bio-Oss was loosely placed in the alveolar socket without condensation and covered with Bio-Gide to reconstruct the defects of the alveolar ridge. Six months later,there were sufficient height and width of the alveolar ridge for the dental implant,avoiding the need of additional bone augmentation and reducing the complexity and unpredictability of the implant surgery. Soft tissue defects,such as gingival and connective tissue,played crucial roles in long-term implant success. Peri-implant plastic surgery facilitated development of healthy peri-implant structure able to withstand occlusal forces and muco-gingival stress. Six months after the implant surgery,the keratinized gingiva was absent in the buccal of the implant and the vestibular groove was a little shallow. The free gingival graft technique was used to solve the vestibulum oris groove supersulcus and the absence of keratinized gingiva around the implant. The deepening of vestibular groove and broadening of keratinized gingiva were conducive to the long-term health and stability of the tissue surrounding the implant. Implant installation and prosthetic restoration showed favorable outcome after six months.

关 键 词：外科手术 微创性 拔牙 牙种植 牙修复体 软组织增量 

分 类 号：R782.1[医药卫生—口腔医学]