背景:立即植入(IIP)与较高的美学并发症风险有关,尤其是颊粘膜凹陷,这在非完整的插座中或在美学区中存在薄表型时更为明显。然而,已经发表了多种技术来解决非完好无损的肺泡窝的IIP,结果良好。这项研究的目的是提出一种在颊骨开裂部位进行IIP的方法。
方法:3名要求在颊骨裂开的情况下拔除一颗或多颗牙齿的患者采用无舌拔除治疗,IIP,引导骨再生(GBR),和结缔组织移植(CTG)通过隧道方法同时使用定制愈合基台。
结果:所有部位在植入平台水平处表现出1-2毫米的颊骨厚度,以及显著的颊软组织厚度,在植入后4个月至1年没有衰退和出现轮廓的有利发展。
结论:带颊骨裂开的牙槽中的IIP可以通过无舌拔除来管理,GBR和CTG通过隧穿方法表现出良好的硬组织和软组织反应。
结论:将即刻植入物放置在不完整的牙槽中时,建议同时进行结缔组织移植,尤其是在美学领域。可以通过隧道方法在颊骨裂开的腔内即时植入物中进行骨移植,而无需开放皮瓣方法。在即时植入物上放置CHA可能有助于维持颊舌脊轮廓以及整体硬软组织反应。
结论:在拔牙后放置牙种植体会导致更明显的美学问题,尤其是口香糖衰退。当牙槽不完整或牙龈组织较薄时,这种情况更为常见。然而,即使在这些具有挑战性的情况下,几种技术也显示出良好的效果。这项研究探索了在拔牙后正确放置植入物的方法,以防牙槽骨缺失。治疗了三名需要拔牙且牙槽外侧骨丢失的患者。治疗包括:在不切割牙龈的情况下提取牙齿,立即放置植入物,使用GBR帮助骨骼再生,增加结缔组织移植物,并使用定制的愈合杯来塑造牙龈组织。治疗后,所有部位均显示植入物外侧有1-2毫米的新骨,牙龈组织较厚,无任何凹陷。4个月到一年后,植入物周围的牙龈和骨头看起来很好。总之,用这种方法可以有效地管理外侧骨丢失的插座中的IIP,导致良好的骨骼和牙龈组织结果。
BACKGROUND: Immediate implant placement (IIP) has been associated with a higher risk of esthetic complications and particularly buccal mucosal recession, which can be more pronounced in non-intact sockets or in the presence of thin phenotype in the esthetic zone. Nevertheless, multiple techniques have been published to address IIP in non-intact alveolar sockets with favorable outcomes. The purpose of this study is to present an approach on IIP in sites with buccal bone dehiscence.
METHODS: Three patients requiring extraction of one or multiple teeth in the presence of buccal bone dehiscence were treated with flapless extractions, IIP, guided bone regeneration (GBR), and connective tissue grafting (CTG) through a tunneling approach with a simultaneous use of custom healing abutments.
RESULTS: All sites exhibited 1-2 mm of buccal bone thickness at the level of the implant platform, as well as significant buccal soft tissue thickness with no recession and a favorable development of the emergence profile at 4 months to a year post implant placement.
CONCLUSIONS: IIP in sockets with buccal bone dehiscence can be managed by means of a flapless extraction, GBR and CTG through a tunneling approach exhibiting favorable hard and soft tissue responses.
CONCLUSIONS: When placing immediate implants in non-intact sockets, simultaneous connective tissue grafting is recommended, especially in the esthetic zone. Bone grafting in immediate implants in sockets with buccal bone dehiscence can be performed through a tunneling approach without the need for open flap approaches. Placement of CHAs over immediate implants may help promote maintenance of the buccolingual ridge contours and overall hard and soft tissue responses.
CONCLUSIONS: Placing dental implants right after tooth extraction can lead to more visible aesthetic issues, especially gum recession. This is more common when the tooth socket is not intact or the gum tissue is thin. However, several techniques have shown good results even in these challenging situations. This study explores a method for implant placement right after tooth extraction in cases where there is bone missing on the socket. Three patients who needed teeth extracted and had bone loss on the outer side of their tooth sockets were treated. The treatment included: Extracting the teeth without cutting the gums, placing implants immediately, using GBR to help regrow bone, adding connective tissue grafts, and using custom healing cups to shape the gum tissue. After treatment, all the sites showed 1-2 mm of new bone on the outer side of the implants and thicker gum tissue without any recession. The gum and bone around the implants looked good 4 months to a year later. In conclusion, IIP in sockets with bone loss on the outer side can be effectively managed with this method, leading to good bone and gum tissue outcomes.