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目的:评估后牙区即刻种植颈部骨组织的改建情况。方法:选择后牙区即刻种植的病例237例,其中上颌后牙区窦底骨高度为5-8mm的98例即刻植入102枚大直径、短种植体,下颌后牙区骨高度为7-10mm的139例即刻植入153枚大直径、短种植体,种植体与拔牙窝骨壁之间的间隙植入自体骨或人工骨代用品,缝合固定胶原塞以关闭拔牙窝。下颌种植体植入3个月行二期手术,上颌种植体植入5-6个月行二期手术,二期术后3-4周完成基台一体化冠永久修复。结果:237例后牙区即刻种植的253枚种植体均获得了良好的骨结合,2枚种植体纤维包裹失败,经重新植入而完成种植修复。经6-48个月的临床观察,种植修复体均获得了较好的临床效果。从一期手术到冠修复完成,种植体颈部骨组织平均吸收0.53mm,负重后观察6-48个月,颈部骨组织较前又平均吸收0.02mm。讨论:当后牙区骨高度较低时,选择大直径、短种植体即刻植入时,种植体初期稳定性的获得、植体与拔牙窝骨壁间隙的处理、拔牙窝的关闭都是外科手术的关键问题。结论:大直径、短种植体用于后牙区即刻种植,不仅能简化手术,获得较为理想的临床效果,且种植体颈部骨组织稳定。
OBJECTIVE: To evaluate the reconstruction of cervical bone immediately implanted in posterior teeth. Methods: Totally 237 cases were implanted in the posterior teeth immediately. Among them, 98 cases with maxillary posterior sinus area 5-8 mm in height were implanted immediately with 102 large diameter and short implants. 139 cases of 10 mm were implanted immediately with 153 large diameter and short implants. The gap between the implants and the wall of the extraction socket was implanted with autologous bone or artificial bone substitute, and the collagen plug was sutured to close the extraction socket. The mandibular implants were implanted in the second stage for 3 months. The maxillary implants were implanted in the second stage for 5-6 months and the second stage for 3-4 weeks. RESULTS: All 253 implants immediately implanted in the posterior teeth of the 237 patients achieved good osseointegration, and the implants of 2 implants failed to be implanted. The implants were repaired by replantation. After 6-48 months of clinical observation, implant prosthesis have received better clinical results. From the first operation to the completion of the crown repair, the average bone tissue of the implant was absorbed 0.53mm in the neck and was observed for 6-48 months after the weight-bearing. The average bone tissue of the neck was absorbed 0.02mm earlier. Discussion: When the height of the hindbrain is low, the initial stability of the implant, the treatment of the osseous wall of the socket and extraction of the socket, and the closure of the socket are all surgically selected when large diameter and short implants are implanted immediately The key issue of surgery. Conclusion: The use of large diameter and short implants for immediate implants in the posterior teeth area not only simplifies the operation but also achieves better clinical results. The implants are stable in the cervical bone.