Sailer Irena, Zembic Anja, Jung Ronald Ernst, Hämmerle Christoph Hans Franz, Mattiola Alessandro
Clinic for Fixed and Removable Prosthodontics and Dental Materials, School of Dentistry, University of Zürich, Plattenstr. 11, 8032 Zurich, Switzerland.
Eur J Esthet Dent. 2007 Autumn;2(3):296-310.
Implant-supported single crowns have become a valid alternative to conventional fixed dental prostheses due to their excellent clinical long-term results. However, along with good survival rates, esthetic factors are important for success in anterior regions. Today, several kinds of implant abutments are offered by implant manufacturers. A choice must be made between standardized and customized abutments; further, different abutment materials such as titanium or various ceramics (alumina, zirconia) are available. Finally, the reconstruction can be cemented on the abutment or screw-retained directly on the implant. When choosing an abutment for an anterior single-unit case, several factors should be considered: visibility of the region (eg, high vs low smile line); biotype of the gingiva; color of the neighboring teeth; and finally, esthetic expectations of the patient. In esthetically demanding situations, customized ceramic abutments are indicated. In patient situations with thin peri-implant soft tissues, zirconia abutments and all-ceramic crowns should be used in combination. In cases with thick mucosa, titanium can be used as the abutment material, combined with metal-ceramic crowns. In order to avoid difficulties removing excess cement, screw-retained reconstructions may be preferred; however, the screw access hole should be positioned palatal to the incisal edge.
由于种植体支持的单冠具有出色的长期临床效果，已成为传统固定义齿的一种有效替代方案。然而，除了良好的存留率外，美学因素对于前牙区的成功也很重要。如今，种植体制造商提供了多种类型的种植体基台。必须在标准化基台和定制基台之间做出选择；此外，还可以使用不同的基台材料，如钛或各种陶瓷（氧化铝、氧化锆）。最后，修复体可以用粘结剂固定在基台上，也可以直接用螺丝固位在种植体上。在为前牙单颗牙病例选择基台时，应考虑几个因素：该区域的可见度（例如，高笑线与低笑线）；牙龈的生物型；邻牙的颜色；以及患者的美学期望。在美学要求较高的情况下，应使用定制陶瓷基台。在种植体周围软组织较薄的患者中，应联合使用氧化锆基台和全瓷冠。在黏膜较厚的情况下，可以使用钛作为基台材料，并结合金属烤瓷冠。为了避免去除多余粘结剂时出现困难，螺丝固位的修复体可能更受青睐；然而，螺丝通道孔应位于切缘的腭侧。
