De Rouck Tim, Collys Kristiaan, Cosyn Jan
Department of Prosthodontics, Vrije Universiteit Brussel (VUB), School of Dental Medicine, Brussels, Belgium.
Int J Oral Maxillofac Implants. 2008 Sep-Oct;23(5):897-904.
The objective of this study was to assess to what extent the outcome of immediate implantation and provisionalization for replacing single maxillary teeth in the esthetic zone is favorable and predictable from biologic and esthetic points of view.
An electronic search (MEDLINE and Cochrane Oral Health Group Specialized Trials Register) and a manual search were performed to detect studies concerning maxillary single-tooth replacements by means of dental implants immediately placed into fresh extraction sockets and provisionalized within the first 24 hours. Only full-text reports on clinical studies published in English up to June 2006 were included. Case reports and reviews on the topic of interest were excluded.
Eleven studies were selected. Based on a qualitative data analysis, implant survival and even management of papilla levels seem predictable following immediate implantation and provisionalization. However, maintaining the midfacial gingival margin may be more problematic, since postextraction bone remodeling and therefore marginal gingival changes will occur irrespective of the timing of the placement of an implant. The long-term impact of this remodeling is currently unclear and needs to be elucidated in future research.
The clinician is recommended to be reserved when considering immediate implant placement and provisionalization for replacing single maxillary teeth in the anterior zone. At the very least, a number of guidelines and prerequisites need to be taken into consideration.
本研究的目的是从生物学和美学角度评估在美学区域即刻种植并临时修复单颗上颌牙的效果在多大程度上是良好且可预测的。
进行电子检索（MEDLINE和Cochrane口腔健康组专业试验注册库）及手工检索，以查找关于通过将牙种植体即刻植入新鲜拔牙窝并在24小时内进行临时修复来替换上颌单颗牙的研究。仅纳入截至2006年6月以英文发表的临床研究全文报告。排除关于感兴趣主题的病例报告和综述。
选取了11项研究。基于定性数据分析，即刻种植并临时修复后种植体存留以及乳头水平的均匀管理似乎是可预测的。然而，维持面中部牙龈边缘可能更具问题，因为拔牙后骨改建会发生，进而导致边缘牙龈改变，而这与种植体植入时间无关。这种改建的长期影响目前尚不清楚，需要在未来研究中阐明。
建议临床医生在考虑在前牙区即刻种植并临时修复单颗上颌牙时持谨慎态度。至少，需要考虑一些指导原则和前提条件。
