Socket Shield Technique for immediate implant placement - clinical, radiographic and volumetric data after 5 years
Socket Shield Technique for immediate implant placement - clinical, radiographic and volumetric data after 5 years
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DOI：
10.1111/clr.13012
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发表时间：
2017-11-01
影响因子：
4.3
通讯作者：
Huerzeler, Markus
中科院分区：
文献类型：
--
作者：
Baeumer, Daniel;Zuhr, Otto;Huerzeler, Markus
目的：拔牙后即刻植入种植体通常伴有周围组织的吸收。临床技术的发展，其中颊部的根保留牙周膜和束骨。这项技术是基于动物研究，显示了利用这种方法保存面部组织的潜力。本研究的目的是更深入地了解该技术在生物学和植入物相关长期并发症方面的安全性，并观察植入物周围组织的临床表现。另一个目的是评估体积的变化，受影响的面部轮廓在长期和美学outcomes.Material和方法：这项研究是一个回顾性的病例系列的10个连续的患者之间的上颌第一前磨牙种植体置换。在拔牙前（t1）和种植体植入后5年（t2）进行种植体植入。三维表面扫描的模型进行数字叠加的面部种植体周围组织轮廓和软组织凹陷的变化进行定量评价。此外，收集临床数据（PPD，BOP，根尖周X线片和照片）。结果：所有种植体愈合无不良事件。种植体周围探查显示健康状况。影像学比较显示植入物肩部的生理性骨重建。面侧在口面方向上的平均组织损失为-0.210.18mm。种植体的平均后退为-0.33 +/-0.23 mm，相邻牙齿为-0.38 +/-0.27 mm。种植体肩关节边缘骨水平的平均丢失在种植体近中面为0.33 +/-0.43 mm，在种植体远端面为0.17 +/-0.36 mm。平均粉红色的美学评分为12recorded.Conclusion：体积分析显示，从拔牙和种植体植入到随访的轮廓变化程度较低。种植体修复时的粘膜萎缩与邻近牙齿的粘膜萎缩相当。在本描述性研究的局限性范围内，窝罩技术在手术时可降低侵入性，并具有较高的美学效果，同时可有效保留面部组织轮廓。在获得前瞻性临床试验形式的更高水平证据之前，不应在常规临床实践中使用该技术。
Objectives: Implant placement immediately after tooth extraction is often accompanied by resorption of surrounding tissues. A clinical technique was developed where the buccal portion of the root is retained to preserve the periodontal ligament and bundle bone. This technique is based on animal studies showing the potential to preserve the facial tissues utilizing this approach. The purpose of this study was to gain more insight regarding the safety of the technique with regard to biological and implant-related long-term complications and to observe the clinical appearance of the peri-implant tissues. Another objective was to evaluate volumetric changes of the affected facial contours in long-term and the esthetic outcomes.Material and Methods: This study is a retrospective case series of 10 consecutive patients with implant replacement between the maxillary first premolars. Impressions were made prior to extraction (t1) and 5years post-implant placement (t2). 3D-surface scans of the casts were digitally superimposed for quantitative evaluation of alterations of the facial peri-implant tissue contours and soft tissue recessions. Additionally, clinical data were collected (PPD, BOP, peri-apical radiographs and photographs).Results: All implants healed without adverse events. Peri-implant probing revealed healthy conditions. The comparison of radiographic images showed physiologic bone remodeling at the implant shoulders. Mean tissue loss on the facial side in oro-facial direction was -0.210.18mm. Average recession at implants was -0.33 +/- 0.23mm and at neighboring teeth -0.38 +/- 0.27mm. Mean loss of the marginal bone level at the implant shoulder amounted to 0.33 +/- 0.43mm at the mesial and 0.17 +/- 0.36mm at the distal aspect of the implants. A mean pink esthetic score of 12 was recorded.Conclusion: Volumetric analysis showed a low degree of contour changes from extraction and implant placement to the follow-ups. Mucosal recession at the implant restoration was comparable to that of the neighboring teeth. Within the limitations of this descriptive study, the socket shield technique offers reduced invasiveness at the time of surgery and high esthetic outcomes with effective preservation of facial tissue contours. This technique should not be used in routine clinical practice until a higher level evidence in the form of prospective clinical trials is available.