Immediate Implant Placement Postextraction Without Flap Elevation
Immediate Implant Placement Postextraction Without Flap Elevation
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DOI：
10.1902/jop.2009.080243
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发表时间：
2009-01-01
影响因子：
4.3
通讯作者：
Clement, John G.
中科院分区：
文献类型：
--
作者：
Chen, Stephen T.;Darby, Ivan B.;Clement, John G.
背景：本回顾性研究的目的是评估上颌中切牙和侧切牙部位即刻单牙种植体（未抬高手术瓣）的软组织和美观效果。方法：选取连续 85 例上颌中切牙和侧切牙即刻单牙种植体（未抬高手术瓣）患者的照片记录。粘膜水平的变化以参考中切牙长度的百分比表示。结果：从手术放置到第一年，观察到近中乳头（-6.2％+/-6.8％），远中乳头（-7.4％+/-7.5％）和面部粘膜（-4.6％+/-6.6％）显着退缩（P <0.001）。与舌侧放置的种植体相比，面部放置在拔牙槽内的种植体的后退更大（P = 0.009）。牙龈边缘最初位于冠状面的部位达到接近与对侧牙齿对称线的粘膜水平。最初水平或顶端的部位未能达到对称线并保持后退。对于牙龈边缘最初水平的位点，25 个薄生物型位点中的 6 个发生 >10% 的退缩，而 19 个厚生物型位点中的 2 个发生退缩。大多数地点都取得了可接受的结果； 10% 到 20% 的部位美学效果不佳。结论：在不抬高手术皮瓣的情况下立即植入种植体与边缘粘膜退缩有关，边缘粘膜退缩可能落在视觉可检测变化的阈值内。种植体肩部的口面部位置和组织生物型是重要的影响因素。牙周病杂志 2009；80：163-172。
Background: The aim of this retrospective study was to assess soft tissue and esthetic outcomes at single-tooth immediate implants placed without flap elevation in maxillary central and lateral incisor sites.Methods: Photographic records of 85 consecutive patients with immediate single-tooth implants in maxillary central and lateral incisors that were placed without elevation of surgical flaps were selected. The change in mucosal level was expressed as a percentage of the length of the reference central incisor.Results: Significant recession of the mesial papilla (-6.2% +/- 6.8%), distal papilla (-7.4% +/- 7.5%), and facial mucosa (-4.6% +/- 6.6%) between surgical placement and I year was observed (P < 0.001). Recession was greater for implants placed facially within the extraction socket compared to those placed lingually (P = 0.009). Sites with gingival margins initially coronal achieved mucosal levels close to the line of symmetry with the contralateral tooth. Sites initially level or apical failed to reach the line of symmetry and remained receded. For sites with initially level gingival margins, recession >10% occurred at six of 25 thin biotype sites compared to two of 19 thick biotype sites. Acceptable outcomes were achieved in the majority of sites; between 10% and 20% of sites had suboptimal esthetic results.Conclusions: Immediate implant placement without elevation of surgical flaps is associated with recession of the marginal mucosa that may fall within the threshold of visually detectable change. The orofacial position of the implant shoulder and the tissue biotype are important contributory factors. J Periodontol 2009;80:163-172.