在文献中,立即植入(IIP)通常与中颊部衰退有关。为了得出IIP后软组织行为的结论,术前美学测量必须考虑在内。对这些前瞻性临床病例系列数据进行分析的目的是阐明术前颊软组织水平(STL)或牙龈表型是否会影响无瓣即时植入物放置和预备(FIIPP)上颌切牙病例后1年的粉红色美学结果。
在97名患者中,进行FIIPP的上颌切牙被替换。在术前(T0)拍摄的光照片上分析STL和表型,术后直接(T1),放置永久性牙冠(T2)后,术后1年(T3)。为了研究术前颊软组织缺乏或过量是否影响了T3时每位患者的总粉红色美学评分(total-PES),在STL缺乏或过量的情况下,通过增加减号(“-”)或加号(“+”)来修改PES-3,分别。
术前,40%的病例表现为中颊部衰退(STL缺乏症),超过19%STL,而在41%的情况下,与对侧牙齿相比,水平相等(STL中性)。术后一年,79%(31/39)的衰退病例表现为软组织增重,而STL过量的病例表现出最高的软组织减少率(94%;17/18)。这导致软组织衰退和过度减少(分别为26%和4%,分别),理想的STL(PES-3评分2)增加到70%。术前软组织衰退(平均T3总PES=12.18)或STL过量(平均T3总PES=11.94)患者的1年美学结果无统计学差异(p=0.577)。在总人口中,71例患者瘦,和26个具有厚表型的被评估。两种表型之间的美学结果无统计学差异(p=0.08)(平均T3总PES=12.30,平均T3总PES=11.65)。
无论表型如何,术前软组织衰退,或过量,术后1年获得了相当高的美学结局.
2015年10月20日获得伦理批准并注册(NTR5583/NL4170)。
Immediate implant placement (IIP) often is related to mid-buccal recession in literature. To draw conclusions about the behavior of the soft tissues following IIP, pre-operative aesthetic measurements have to be taken into account. The aim of analysis of these prospective clinical case series data was to elucidate whether the pre-operative buccal soft tissue level (STL) or gingival phenotype influence the 1-year pink aesthetic outcome after performing flapless immediate implant placement and provisionalization (FIIPP) maxillary incisor cases.
In 97 patients, a maxillary incisor was replaced performing FIIPP. STL and phenotype were analyzed on light-photographs made pre-operatively (T0), direct post-operatively (T1), after placement of the permanent crown (T2), and 1 year post-operatively (T3). To investigate if a pre-operative buccal soft tissue deficiency or excess influenced the total pink esthetic score (total-PES) per patient at T3, PES-3 was modified by adding a minus (\"-\") or plus (\"+\") in case of a STL-deficiency or excess, respectively.
Pre-operatively, 40% of the cases showed a mid-buccal recession (STL-deficiency), 19% STL-excess, while in 41% an equal level in comparison with the contra-lateral tooth was observed (STL-neutral). One year post-operatively, 79% (31/39) of the recession cases showed soft tissue gain, while STL-excess cases showed the highest rate of soft tissue reduction (94%; 17/18). This resulted in a decrease of soft tissue recessions and excesses (to 26% and 4%, respectively), and an increase of ideal STL (PES-3-score 2) to 70%. The 1-year aesthetic outcome was not statistically different (p = 0.577) between patients with a pre-operative soft tissue recession (mean T3 total-PES = 12.18) or STL excess (mean T3 total-PES = 11.94). Of the total population, 71 patients with a thin, and 26 with a thick phenotype were evaluated. No statistical difference (p = 0.08) was present in aesthetic outcome between the two phenotypes (thin mean T3 total-PES = 12.30, thick mean T3 total-PES = 11.65).
Regardless of phenotype, preoperative soft tissue recession, or excess, comparable high aesthetic outcomes were achieved 1 year post-operatively.
Ethical approval was obtained and registered on 20 October 2015 ( NTR5583/NL4170 ).