摘要
近年来,即刻种植因其可缩短治疗周期、简化治疗程序成为研究热点。多项研究表明磨牙即刻种植植体生存率较高,具有较高的可实施性。但磨牙区存在上颌窦及下牙槽神经等解剖结构,且磨牙拔牙窝比常规植体更宽,骨量不足等各种因素导致磨牙区的即刻种植获得初期稳定性较为困难,需要临床医生严阵以待。进行磨牙即刻种植首先应严格选择适应症,在拔除牙根时应谨慎处理,以保存完整的牙槽间隔从而获得良好的初期稳定性,上颌窦底的骨皮质也可为种植体提供良好的硬组织支持,同时植体植入时磨牙牙根可辅助植体定位。磨牙即刻种植时,翻瓣与否不会影响种植体的生存率、成功率及边缘骨吸收,并且牙槽窝内的反应性软组织可使角化龈的变化得到改善;对于植体植入后与拔牙窝之间的间隙内是否植入骨粉,众位学者众说纷纭,但无论植骨与否,均可获得良好的植体生存率。植体植入后,多数学者仍然建议磨牙即刻种植最好行常规负荷,常规负荷的时间一般为3-6个月。在前牙区根盾技术开展如火如荼的今天,磨牙区根盾技术也开始被研究,但仍建议有一定经验的临床医生进行操作。在本文中针对以上所述方面进行了展开叙述,为开展磨牙即刻种植的临床工作者们提供一定的参考。
In recent years,immediate implantation has become a research focus because it can shorten thetreatment cycle and simplify the treatment procedure.A number of studies have shown that immediate molarimplants have a higher survival rate and higher feasibility.However,there are anatomical structures such asmaxillary sinus and inferior alveolar nerve in the molar area,and the molar extraction sockets are often wider thanconventional implants.Various factors such as insufficient bone mass make it difficult to obtain initial stability forimmediate implantation in the molar area,requiring clinicians stand up.For immediate implantation of molars,theindications should be strictly selected,and root extraction should be handled carefully to preserve the completealveolar space and obtain good initial stability.The cortex of the maxillary sinus floor can also provide good hardtissue support for the implant,and the roots of molars can assist implant positioning.When the molars areimmediately implanted,whether the flap surgery was taken or not will not affect the survival rate,success rate andedge bone resorption of the implant,and the reactive soft tissue in the alveolar socket can improve the changes of keratinized gingiva.Scholars have different opinions on whether bone materials should be implanted in the gapbetween the implant and the extraction socket.However,regardless of whether the bone materials are implanted ornot,a good survival rate of the implant can be obtained.Most scholars still suggest that immediate molarimplantation is best for routine loading,and the routine loading time is generally 3-6 months.Today,the root shieldtechnology in the anterior tooth area is in full swing,the root shield technology in the molar area has also begun tobe studied,but it is still recommended to have a certain experience of clinicians for the operation.In this article,theabove-mentioned aspects are described,which can provide a certain reference for clinicians who carry outimmediate implantation of molars.
作者
董淑逸
毕润宏
文勇
DONG Shu-yi;BI Run-hong;WEN Yong(Department of Implantology,School and Hospital of Stomatol-ogy,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Shandong Key Laboratory of Oral Tissue Regeneration,Jinan 250012,China;Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration,Jinan 250012,China)
出处
《口腔颌面修复学杂志》
2021年第5期380-384,共5页
Chinese Journal of Prosthodontics
基金
山东大学临床研究培育项目(项目编号:2020SDUCRCC006)
临床医学科技创新计划(项目编号:202019053)。
关键词
磨牙
即刻种植
初期稳定性
种植位点
molar
dental implantation
initial stability
implantation site
