上颌前牙区应用根膜技术即刻种植的临床效果观察

doi:10.7518/hxkq.2019.06.008

华西口腔医学杂志 ›› 2019, Vol. 37 ›› Issue (6): 615-620.doi: 10.7518/hxkq.2019.06.008

上颌前牙区应用根膜技术即刻种植的临床效果观察

闫圣杰^1,²,周聪^1,²,刘金^1,³,许香娜^1,²,杨云^1,²,陈鑫^1,²,兰晶^1,²()

^1. 山东省口腔组织再生重点实验室
^2. 山东大学口腔医学院·口腔医院种植科;
^3. 修复科,济南 250012

收稿日期:2019-04-13 修回日期:2019-08-02 出版日期:2019-12-01 发布日期:2019-11-27
通讯作者: 兰晶 E-mail:kqlj@sdu.edu.cn
作者简介:闫圣杰,硕士,E-mail：2390445758@qq.com
基金资助:
山东省自然科学基金(ZR2015HM065)

Clinical evaluation of the socket-shield technique for immediate implantation in the maxillary anterior region

Yan Shengjie^1,²,Zhou Cong^1,²,Liu Jin^1,³,Xu Xiangna^1,²,Yang Yun^1,²,Chen Xin^1,²,Lan Jing^1,²()

^1. Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Jinan 250012, China
^2. Dept. of Implantology, School & Hospital of Stomatology, Shandong University, Jinan 250012, China;
^3. Dept of Prosthodontics, School & Hospital of Stomatology, Shandong University, Jinan 250012, China;

Received:2019-04-13 Revised:2019-08-02 Online:2019-12-01 Published:2019-11-27
Contact: Jing Lan E-mail:kqlj@sdu.edu.cn
Supported by:
Natural Science Foundation of Shandong Province(ZR2015HM065)

摘要/Abstract

摘要：

目的观察上颌前牙区应用根膜技术即刻种植1年后的临床效果。方法选取10例上颌前牙区牙齿不能保留的患者,应用根膜技术保留唇侧根片并同期植入种植体,术后6个月行永久冠修复,术后1年复查。术后1年统计种植体存留率;测量术后即刻和术后1年种植体唇侧硬组织厚度;统计术后1年种植修复体牙间乳头外形,并对修复体的红白美学进行评分;统计并发症发生情况及患者对治疗过程的满意度。结果术后1年复查,种植体存留率为100%;种植体唇侧颈、中、根部硬组织厚度相较于术后即刻分别减少（0.27±0.21）、（0.19±0.20）、（0.28±0.29） mm;术后1年3个测量位点唇侧硬组织的厚度与术后即刻相比,差异均有统计学意义（P<0.05）,但3个位点硬组织厚度的变化量无明显差异（P>0.05）;修复体牙间乳头大多充满邻间隙,粉红色美学指数为9.10±0.54,白色美学指数为9.00±0.63;术后无明显并发症,患者满意度高。结论根膜技术应用于上颌前牙区无法完全避免种植体唇侧硬组织的吸收,但短期修复美学效果良好,长期的临床效果仍需进一步随访观察。

关键词: 根膜技术, 即刻种植, 美学区种植

Abstract:

Objective This study aimed to evaluate the clinical effect of the socket-shield technique in the maxillary anterior region at one year after implant placement.Methods Ten patients with maxillary anterior teeth that cannot be reserved were enrolled. Implants were installed following the socket-shield technique and restored six months after the surgery. The thickness of the labial maxillary bone of the implant was compared before and one year after the surgery. At one year follow-up, the retention rate of the implants, Jemt classification, and pink and white aesthetic scores were evaluated. Postoperative complications and patient satisfaction were also analyzed.Results One year after installation, the retention rate of the implant was 100%. The thickness of the maxillary bone at the neck, central, and root section of the implant reduced to (0.27±0.21), (0.19±0.20), and (0.28±0.29) mm, respectively, compared with the values immediately after the operation. The thickness of the labial maxillary bone at the three measurement points immediately after and one year after the operation was statistically significant (P<0.05). No significant difference (P>0.05) of the difference thickness between immediate and one year after operation at the three measurement points. The pink esthetic scores of the implant prosthesis was 9.10±0.54, and the white esthetic scores was 9.00±0.63. No complications were observed, and the patients had a high degree of satisfaction.Conclusion The socket-shield technique could provide acceptable treatment results but cannot completely avoid the reconstruction of the labial maxillary bone of the implants. The technique exhibits favorable short-term aesthetic result, but its long-term clinical effect and aesthetic problems need to be further studied.

Key words: socket-shield technqiue, immediate implant, aesthetic area implant

中图分类号:

R783

闫圣杰,周聪,刘金,许香娜,杨云,陈鑫,兰晶. 上颌前牙区应用根膜技术即刻种植的临床效果观察[J]. 华西口腔医学杂志, 2019, 37(6): 615-620.

Yan Shengjie,Zhou Cong,Liu Jin,Xu Xiangna,Yang Yun,Chen Xin,Lan Jing. Clinical evaluation of the socket-shield technique for immediate implantation in the maxillary anterior region[J]. West China Journal of Stomatology, 2019, 37(6): 615-620.

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参考文献 19

[1]	Lang NP, Pun L, Lau KY , et al. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year[J]. Clin Oral Implants Res, 2012,23(Suppl 5):39-66. doi: 10.1111/j.1600-0501.2011.02372.x URL pmid: 22211305
[2]	Chen ST, Buser D . Esthetic outcomes following immediate and early implant placement in the anterior maxilla: a systematic review[J]. Int J Oral Maxillofac Implants, 2014,29(Suppl):186-215. doi: 10.11607/jomi.2014suppl.g3.3 URL pmid: 24660198
[3]	Hürzeler MB, Zuhr O, Schupbach P , et al. The socket-shield technique: a proof-of-principle report[J]. J Clin Periodontol, 2010,37(9):855-862. doi: 10.1111/j.1600-051X.2010.01595.x URL pmid: 20712701
[4]	Jemt T . Regeneration of gingival papillae after single-implant treatment[J]. Int J Periodontics Restorative Dent, 1997,17(4):326-333. URL pmid: 9497723
[5]	Belser UC, Grütter L, Vailati F , et al. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores[J]. J Periodontol, 2009,80(1):140-151. doi: 10.1902/jop.2009.080435 URL pmid: 19228100
[6]	Casey DM, Lauciello FR . A review of the submerged-root concept[J]. J Prosthet Dent, 1980,43(2):128-132. doi: 10.1016/0022-3913(80)90174-2 URL pmid: 6766189
[7]	Schwimer C, Pette G, Gluckman H , et al. Human histologic evidence of new bone formation and osseointegration between root dentin (unplanned socket-shield) and dental implant: case report[J]. Int J Oral Maxillofac Implants, 2018,33(1):e19-e23. doi: 10.11607/jomi.6215 URL pmid: 29340355
[8]	Bäumer D, Zuhr O, Rebele S , et al. Socket shield technique for immediate implant placement—clinical, radiographic and volumetric data after 5 years[J]. Clin Oral Implants Res, 2017,28(11):1450-1458. doi: 10.1111/clr.13012 URL pmid: 28333394
[9]	Petsch M, Spies B, Kohal RJ . Socket shield technique for implant placement in the esthetic zone: a case report[J]. Int J Periodontics Restorative Dent, 2017,37(6):853-860. doi: 10.11607/prd.2729 URL pmid: 29023617
[10]	Degidi M, Daprile G, Nardi D , et al. Buccal bone plate in immediately placed and restored implant with Bio-Oss ^® collagen graft: a 1-year follow-up study [J]. Clin Oral Implants Res, 2013,24(11):1201-1205. doi: 10.1111/j.1600-0501.2012.02561.x URL pmid: 22882574
[11]	Roe P, Kan JY, Rungcharassaeng K , et al. Horizontal and vertical dimensional changes of peri-implant facial bone following immediate placement and provisionalization of maxillary anterior single implants: a 1-year cone beam computed tomography study[J]. Int J Oral Maxillofac Implants, 2012,27(2):393-400. URL pmid: 22442780
[12]	赵彤 . 上颌前牙区种植同期GBR术后骨量变化的临床CBCT研究[D]. 杭州: 浙江大学, 2016.
	Zhao T . Bone alterations on maxillary anterior implants with simultaneous GBR—a clinical and cone beam computed tomography study[D]. Hangzhou: Zhejiang University, 2016.
[13]	Gluckman H , Salama M, du Toit J. Partial extraction therapies (PET) part 2: procedures and technical aspects[J]. Int J Periodontics Restorative Dent, 2017,37(3):377-385. doi: 10.11607/prd.3111 URL pmid: 28402349
[14]	Siormpas KD, Mitsias ME, Kontsiotou-Siormpa E , et al. Immediate implant placement in the esthetic zone utilizing the “root-membrane” technique: clinical results up to 5 years postloading[J]. Int J Oral Maxillofac Implants, 2014,29(6):1397-1405. doi: 10.11607/jomi.3707 URL pmid: 25265125
[15]	Mitsias ME, Siormpas KD, Kontsiotou-Siormpa E , et al. A step-by-step description of PDL-mediated ridge preservation for immediate implant rehabilitation in the esthetic region[J]. Int J Periodontics Restorative Dent, 2015,35(6):835-841. doi: 10.11607/prd.2148 URL pmid: 26509987
[16]	Benic GI, Hammerle CH . Horizontal bone augmentation by means of guided bone regeneration[J]. Periodontol 2000, 2014,66(1):13-40. doi: 10.1111/prd.12039 URL pmid: 25123759
[17]	Gluckman H ,Salama M, du Toit J. A retrospective evaluation of 128 socket-shield cases in the esthetic zone and posterior sites: partial extraction therapy with up to 4 years follow-up[J]. Clin Implant Dent Relat Res, 2018,20(2):122-129. doi: 10.1111/cid.12554 URL pmid: 29178381
[18]	Davarpanah M, Szmukler-Moncler S, Rajzbaum P , et al. Unconventional implant placement. Ⅴ: implant placement through impacted teeth; results from 10 cases with an 8- to 1-year follow-up[J]. Int Orthod, 2015,13(2):164-180. doi: 10.1016/j.ortho.2015.03.015 URL pmid: 26005033
[19]	Nevins ML, Langer L, Schupbach P . Late dental implant failures associated with retained root fragments: case reports with histologic and SEM analysis[J]. Int J Periodontics Restorative Dent, 2018,38(1):9-15. doi: 10.11607/prd.3463 URL pmid: 29240199

参数	2分	1分	0分
近中龈乳头	完整	不完整	缺失
远中龈乳头	完整	不完整	缺失
牙龈曲线弧度（参考对侧同名牙）	协调	稍有不同	明显不同
牙龈曲线高度（参考对侧同名牙）	相同	相差1 mm以内	相差1 mm以上
种植体部对应黏膜的凸度、颜色和质地（参考对侧同名牙）	3个参数相同	2个参数相同	1个或无参数相同

参数（参考对侧同名牙）	2分	1分	0分
修复体形状	相同	稍有不同	明显不同
修复体轮廓和体积	相同	稍有不同	明显不同
修复体颜色	相同	稍有不同	明显不同
修复体表面质地	相同	稍有不同	明显不同
修复体透明度和个性化处理	相同	稍有不同	明显不同

测量位点	术后即刻	术后1年	术后即刻与术后1年的差值^#
B-OC	3.09±0.67	2.83±0.67*	0.27±0.21
MS-OMS	3.04±1.08	2.85±1.16*	0.19±0.20
LS-OLS	3.90±2.05	3.62±2.01*	0.28±0.29

上颌前牙区应用根膜技术即刻种植的临床效果观察

Clinical evaluation of the socket-shield technique for immediate implantation in the maxillary anterior region

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