拔牙后,骨和软组织的建模和重塑阶段发生。已经充分证明,骨吸收高达50%的骨吸收可以发生关于脊的宽度和变量关于脊的高度,很难进行植入手术。
意大利骨整合学院(IAO)的积极成员参加了这次共识会议,会议前进行了三项系统评价,以提供有关牙槽嵴保存程序的指南。系统综述涵盖以下主题:(1)什么材料可以最好地保持水平和垂直方向上的牙脊尺寸?;(2)什么材料有利于形成最大量的新骨?;(3)哪种技术可以最好地密封牙窝?;(4)牙槽脊保存对软组织有什么影响?
该组件得出的主要结论是建议在拔牙后保留牙槽脊,特别是在美学领域,在解剖结构附近(即,上颌窦,下牙槽神经,和精神孔),每当治疗计划需要延迟安置时,每当患者出于各种原因要求推迟植入物插入时。建议在使用“再生材料”之前进行插座清创,“和异种移植物被认为是保持脊尺寸的黄金标准材料。另一个适应症是抗生素治疗,建议在保留牙槽脊的情况下(干预前1小时阿莫西林2g,每12小时1g,持续6天)。应使用膜或自体软组织来密封插座并保护再生材料,指示的再入时间(植入物插入)为4至6个月。
本次共识会议一致认为,采用牙槽嵴保存措施可有效预防生理性骨丢失,尤其是在美学领域。建议用膜或自体软组织覆盖异种移植材料,建议使用抗生素治疗。
After tooth extraction, a modeling and remodeling phase of bone and soft tissues occurs. It has been fully demonstrated that bone resorption as high as 50% can take place regarding ridge width and a variable amount concerning ridge height, making it difficult to perform implant surgery.
Active members of the Italian Academy of Osseointegration (IAO) participated in this
Consensus Conference, and three systematic reviews were conducted before the meeting to provide
guidelines on alveolar ridge preservation procedures. The systematic reviews covered the following topics: (1) What material best preserves the dimensions of the ridge horizontally and vertically?; (2) what material favors the formation of the highest quantity of new bone?; (3) which technique would best seal the socket?; and (4) what effect does alveolar ridge preservation have on soft tissues?
The main conclusions reached by the assembly were that alveolar ridge preservation is advisable after dental extraction, particularly in esthetic areas, in proximity of anatomical structures (ie, maxillary sinus, inferior alveolar nerve, and mental foramen), whenever the treatment plan requires delayed placement, and whenever patients ask to postpone implant insertion for various reasons. Socket debridement is advised before the use of a \"regenerative material,\" and xenograft is considered the gold standard material to maintain ridge dimensions. Another indication is antibiotic therapy, which is recommended in the case of alveolar ridge preservation (amoxicillin 2 g 1 hour before the intervention and 1 g every 12 hours for 6 days). A membrane or autologous soft tissue should be used to seal the socket and protect the regenerative material, and the indicated reentry time (implant insertion) is 4 to 6 months.
This
Consensus Conference agreed that the adoption of alveolar ridge preservation can effectively prevent physiologic bone loss, especially in esthetic areas. It is recommended to cover the xenograft material with a membrane or autologous soft tissue, and antibiotic therapy is advisable.