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目的:探讨上颌前牙翻瓣植骨即刻种植病例修复后的美学效果与长期效果的稳定性,就治疗计划的制定、种植正畸联合治疗、种植外科技术及修复技术等进行初步探讨。方法:19例在北京大学口腔医院种植科就诊可行上颌前牙即刻种植的患者纳入本研究,拔牙即刻植入种植体,同期行GBR技术,软组织成形术,种植体达到骨结合后完成永久修复。美学评价指标包括牙龈乳头水平及唇侧软组织丰满度。结果:共植入22种植体,平均追踪时间41.5个月(24-66个月),至最后一次复查未见种植体脱落,临床美学效果好。修复后即刻与修复后2年比较牙间乳头及唇侧丰满度改变无统计学差异(P>0.05)。讨论:术前正确的诊断与选择正确的治疗计划是即刻种植成功第一步。外科技术的关键是重建缺损的软硬组织,其中即刻种植时软组织伤口的关闭关系到种植体能否到达骨结合及愈合后软组织丰满情况。通过种植暂时冠对牙龈进行塑形及永久修复时修复方式、材料的选择关系到牙龈组织的长期稳定,临床上需根据患者具体情况选择。结论:根据本研究有限的的数据提示上颌前牙翻瓣植骨即刻种植可以达到良好的临床及美学效果,患者满意度高。
Objective: To explore the aesthetics and long-term stability of the immediate anterior maxillary anterior flap valve implant after repair, and to discuss the treatment plan, implant orthodontic treatment, implant surgery and repair techniques. Methods: Twenty-nine patients who underwent immediate dental implantation in the Department of Stomatology, Stomatology Hospital of Peking University were enrolled in this study. Implants were implanted immediately after tooth extraction. GBR and soft tissue plasty were performed in the same period. Aesthetic evaluation indicators include the level of gingival papilla and labial soft tissue fullness. Results: A total of 22 implants were implanted with an average follow-up time of 41.5 months (24-66 months). No implants were found in the last review, and clinical aesthetics was good. There was no significant difference in the plumpness between the interdental nipples and the labia immediately after the repair and 2 years after the repair (P> 0.05). Discussion: Correct Preoperative Diagnosis and Selection The right treatment plan is the first step in immediate success. The key to surgical technique is to reconstruct the damaged soft and hard tissue. The closure of the soft tissue wound immediately implanted is related to the ability of the implant to reach the osseous and soft tissue after healing. Through the cultivation of temporary crown on the gums and permanent repair of the repair, the choice of materials related to the long-term stability of gingival tissues, clinically based on the specific circumstances of patients to choose. CONCLUSIONS: Based on the limited data presented in this study, immediate implant of the maxillary anterior flap can achieve good clinical and aesthetic results with high patient satisfaction.