Ishikawa Tomohiro, Salama Maurice, Funato Akiyoshi, Kitajima Hajime, Moroi Hidetada, Salama Henry, Garber David
University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Int J Periodontics Restorative Dent. 2010 Oct;30(5):503-11.
Achieving an esthetic outcome in tooth replacement and implant treatment requires a proper tooth shape and stable surrounding soft tissue profiles. Bone augmentation is considered vital to support the esthetic soft tissue profile around definitive restorations. To prevent recession of the peri-implant soft tissue in cases with multiple implants, buccal bone augmentation of more than 2 mm from the implant platform is necessary to overcome the normal pattern of bone remodeling. Drawing an imaginary horizontal line spanning the space between the remaining healthy interproximal bone peaks is the most reliable vertical augmentation target to create esthetic papillae around an implant prosthesis. Provided that the adjacent bone peaks are at an ideal height and the bone is augmented vertically up to this line, the accepted general guideline of 2 to 3 mm of interproximal vertical bone augmentation from ideally placed implant platforms will invariably also be achieved. In addition, placing pontics in strategic positions to avoid consecutively placed implants has been suggested to facilitate vertical bone height preservation after bone augmentation. Even with esthetically successful results, there have been very few long-term studies on compromised cases with multiple implants. This will become more and more critical over time and must be remedied.
在牙齿修复和种植治疗中实现美学效果需要合适的牙齿形状和稳定的周围软组织轮廓。骨增量被认为对于支持最终修复体周围的美学软组织轮廓至关重要。为防止多颗种植病例中种植体周围软组织退缩，从种植体平台起颊侧骨增量超过2毫米对于克服正常的骨重塑模式是必要的。在剩余健康邻间骨嵴之间的间隙画一条假想的水平线，是在种植体修复体周围创建美学龈乳头最可靠的垂直增量目标。假设相邻骨嵴处于理想高度且骨垂直增量至该线，理想位置的种植体平台间2至3毫米的邻间垂直骨增量这一公认的一般指导原则也将必然实现。此外，有人建议将桥体放置在战略位置以避免种植体连续放置，以利于骨增量后垂直骨高度的保留。即使取得了美学上的成功结果，关于多颗种植的受损病例的长期研究也非常少。随着时间的推移，这将变得越来越关键，必须加以补救。
