下颌后牙区即刻种植综合序列治疗新方案  

New clinical operation of comprehensive sequential treatment for immediate implant placement in the posterior mandibular region

作　　者：周琴[1] 赵正宜 邹多宏[1] 杨驰[1] 张志愿[1] Zhou Qin;Zhao Zhengyi;Zou Duohong;Yang Chi;Zhang Zhiyuan(Department of Oral Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Research Unit of Oral and Maxillofacial Regenerative Medicine,Chinese Academy of Medical Sciences,Shanghai 200001,China;Department of Oral Implant,Stomatologic Hospital&College,Anhui Medical University Key Lab.of Oral Diseases Research of Anhui Province,Hefei 230032,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔外科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,中国医学院口腔颌面再生医学创新单元,合肥230032 [2]安徽医科大学口腔医学院,合肥230032

出　　处：《中国口腔种植学杂志》2022年第2期93-98,共6页Chinese Journal of Oral Implantology

基　　金：中国医学科学院医学与健康科技创新工程项目资助(2019-I2M-5-037);国家自然科学基金(31870969,32171347);上海交通大学医学院“双百人”人才计划(20191816)。

摘　　要：目的前牙区即刻种植技术日趋成熟与普及,前牙区关注美学修复,而后牙区更注重咀嚼功能的恢复。由于下颌后牙多为双根牙,牙拔除后即刻种植面临牙槽间隔备洞时容易发生近远中偏差,影响种植体的精准植入。为解决这一临床问题,本研究进行了新治疗方案的探索与实践。方法本团队总结出一套“下颌后牙区即刻种植综合序列治疗新方案”的新方法,微创拔除无保留价值的下颌后牙,最大可能保存牙槽间隔的骨量及牙槽窝的骨壁,精准地将种植体植入牙槽窝间隔处,并研发了后牙区即刻种植专用系列手术器械,申请了18项专利,完成了成果转化及医疗产品生产和临床应用。结果临床验证了该方案可以精准植入种植体,且增加了后牙种植体的初始稳定性。结论该方案有利于种植体植入理想位置,有效提高下颌后牙即刻种植的成功率,值得推广。Objective Immediate implant placement has been widely employed in the anterior teeth area.Unlike the immediate implantation in the anterior zone which serve the patients’aesthetic needs,treatment in the posterior region pays more attention to the recovery of masticatory function.However,most of the mandibular posterior teeth consist of two roots,implants that are placed immediately after extraction of posterior teeth are prone to mesial-distal deviation when drilling in the interradicular septa,which will ultimately affect the axial direction of the implants.This article introduces an exploration and practice of new treatment for immediate implantation in the posterior mandibular area,which can effectively solve the above problems.Methods Our team summed up a new method of“a comprehensive sequential treatment plan for immediate implantation of posterior mandibular teeth”,minimally invasive extraction of unreserved mandibular posterior teeth,and the maximum possible preservation of the volume of interradicular bone and the bone wall of the alveolar socket,accurate placement of implants in the alveolar socket interval.To this end,we have developed a special series of surgical instruments for immediate implantation in the posterior teeth area,applied for 18 patents,and completed the achievements of transformation and the production and clinical application of medical products.Results Clinical application confirmed that this method increased the initial stability and precision of implants of mandibular posterior teeth.Conclusion This scheme is conducive to the ideal position of implant placement effectively improving the success rate of immediate implantation of mandibular posterior teeth and is worthy of clinical promotion.

关 键 词：下颌后牙 即刻种植 精准植入 综合序列治疗 规范化操作 

分 类 号：R783.6[医药卫生—口腔医学]