García Berta, Boronat Araceli, Larrazabal Carolina, Peñarrocha María, Peñarrocha Miguel
Valencia University Medical and Dental School, Valencia, Spain.
Int J Oral Maxillofac Implants. 2009 Mar-Apr;24(2):348-52.
When impacted maxillary canines are not amenable to orthodontic traction or reimplantation, extraction is the only solution available, followed by the option of implant placement. The aim of this study was to present a surgical technique that allows placement of immediate implants following extraction of impacted maxillary canines.
Included in the study were patients with impacted maxillary canines who refused orthodontic treatment or transplantation and/or in whom the position of the canine teeth did not allow fenestration and orthodontic traction. The canines were removed, with the apical and ridge crest bone preserved to allow immediate implant placement anchored bicortically with good primary stability. The full circumference of the implants had no bone coverage except for the apical and coronal parts and were covered with bone shavings collected by the filter of the surgical aspirator during ostectomy. The definitive restorations were positioned after a healing period of 2 to 3 months. After 12 months, data were recorded relating to the clinical and radiographic condition of the implants.
Ten impacted maxillary canines were extracted from nine patients (in one patient, both impacted maxillary canines were extracted) with a mean age of 40.3 years (range, 32 to 63 years), and 10 immediate implants were placed. All the implants had primary stability with a mean Osstell value of 61.5 on the day of surgery. At 12 months of follow-up, all the implants were considered to be successful. Digital periapical radiographs demonstrated a mean peri-implant bone loss of 0.49 mm (range, 0.15 to 1.1 mm).
The removal of impacted canines followed by immediate implant placement minimizes the number of surgical interventions and the waiting time, although increased surgical skill is needed to place the implants.
当埋伏阻生的上颌尖牙无法通过正畸牵引或再植术处理时,拔牙是唯一可行的解决办法,之后可选择种植修复。本研究的目的是介绍一种外科技术,该技术可在拔除埋伏阻生的上颌尖牙后即刻植入种植体。
本研究纳入的患者为拒绝正畸治疗或移植,和/或尖牙位置不允许开窗及正畸牵引的埋伏阻生上颌尖牙患者。拔除尖牙时保留根尖和牙槽嵴顶骨质,以便即刻植入种植体,使其获得良好的初期稳定性并实现双侧皮质骨锚固。种植体除根尖和冠部外,整个圆周均无骨覆盖,在牙槽骨切除术期间,种植体被手术吸引器过滤器收集的骨屑覆盖。在2至3个月的愈合期后进行最终修复。12个月后,记录与种植体临床和影像学状况相关的数据。
从9例患者中拔除了10颗埋伏阻生的上颌尖牙(1例患者拔除了双侧埋伏阻生的上颌尖牙),患者平均年龄40.3岁(范围32至63岁),并植入了10颗即刻种植体。所有种植体均具有初期稳定性,手术当天平均Osstell值为61.5。随访12个月时,所有种植体均被认为成功。数字化根尖片显示种植体周围平均骨吸收为0.49mm(范围0.15至1.1mm)。
拔除埋伏阻生尖牙后即刻植入种植体可减少手术干预次数和等待时间,尽管植入种植体需要更高的手术技巧。