Juodzbalys Gintaras, Wang Hom-Lay
Department of Oral and Maxillofacial Surgery, Kaunas University of Medicine, Kaunas, Lithuania.
Clin Oral Implants Res. 2007 Apr;18(2):237-43. doi: 10.1111/j.1600-0501.2006.01312.x.
The aim of this prospective study was to evaluate clinically and radiographically the success and esthetic result of immediate implant placement at the time of extraction.
Twelve patients with 14 titanium screw-shaped implants (13-16 mm length and 4.3 or 5 mm diameters) were placed in the extraction sockets. Defects after implant placement were recorded, and then filled up with deproteinized bovine bone mineral, bioabsorbable collagen membrane, and absorbable pins. The defect was again re-evaluated at second-stage surgery. Clinical and radiographic parameters of the peri-implant conditions were assessed at the moment of prosthesis placement and at 1-year follow-up.
The cumulative implant survival and success rate was 100% after a 1-year observation period. Analysis of the esthetic result showed that the mean pink esthetic score (PES) was 11.1 (SD 1.35) at 1-year follow-up. At 1 year, 64.3% papillae had a score of 2 and the remaining 35.7% score 3 according to the Jemt (1997) papillary index. Optimal value of width of the keratinized mucosa was recorded in 13 (92.9%) implant cases in both periods of follow-up. At 1-year follow-up, the linear distance between implant-shoulder to the bone peaks remains stable with a mean of 2.62+/-0.2 mm at the mesial and 2.9+/-0.58 mm at the distal aspect.
Careful evaluation of potential extraction sites before immediate implant installation promotes optimal implant esthetics.
本前瞻性研究旨在从临床和影像学方面评估拔牙时即刻种植的成功率和美学效果。
12例患者共植入14枚钛质螺旋形种植体(长度为13 - 16毫米,直径为4.3或5毫米),植入拔牙窝。记录种植体植入后的骨缺损情况,然后用脱蛋白牛骨矿物质、生物可吸收胶原膜和可吸收钉填充。在二期手术时再次评估骨缺损情况。在义齿修复时及随访1年时评估种植体周围状况的临床和影像学参数。
经过1年的观察期,种植体的累积存留率和成功率均为100%。美学效果分析显示,随访1年时平均粉色美学评分(PES)为11.1(标准差1.35)。根据Jemt(1997)乳头指数,1年时64.3%的乳头评分为2分,其余35.7%评分为3分。在两个随访期,13例(92.9%)种植体病例的角化黏膜宽度记录为最佳值。随访1年时,种植体肩部至骨嵴的线性距离保持稳定,近中平均为2.62±0.2毫米,远中平均为2.9±0.58毫米。
在即刻种植前仔细评估潜在拔牙部位可促进种植体达到最佳美学效果。