DE Vico G, Spinelli D, Bonino M, Schiavetti R, Pozzi A, Ottria L
Department of Odontostomatologic Science, University of Rome "Tor Vergata", Rome, Italy.
Oral Implantol (Rome). 2012 Jan;5(1):3-10. Epub 2012 Jul 17.
It has been suggested that for success with immediate loaded dental implants it is necessary that, prior to their placement, bone quality and quantity as well as the biomechanical environment in which the implants are to function be evaluated.However, conventional techniques currently used for immediate implant placement lack sufficient precision and are usually accomplished by opening flap procedures. Nowadays computer-guided flapless surgery for implant placement using stereolithographic templates is gaining popularity among clinicians and patients. The advantages of this surgical protocol are its minimally invasive nature, accuracy of implant placement, predictability, less post-surgical disconfort and reduced time required for definitive rehabilitation. The introduction of digital planning programs has made it possible to place dental implants in preplanned positions and being immediately functionally loaded by using prefabricated prostheses. The surgical guide is used, infact, to develop a master model and fabricate the provisional bridge that will be secured to the implants immediately after their placement using the guided surgery template. In this way patients are able to achieve, in the same day of the surgery, a comfortable fixed rehabilitation needing only minor occlusal adjustments. Job S. et al during the three-month period, have demonstrated that the average reduction of crestal bone height around the implants placed with flapless surgery (0.06 mm) is not statistically significant, while the average reduction of crestal bone height around the implants placed using flap surgery (0.4 mm) is statistically significant, concluding that the use of stereolithographic appliances in accordance with flapless surgery makes immediate placement of the implants more predictable. However, the documentation of this technique in partial rehabilitations is limited. PURPOSE of this paper is to report the benefit of sophisticated pre-operative diagnostic implant planning and a flapless surgical approach with immediate loading in the rehabilitation of partial edentulies.
有人认为,要使即刻负重牙种植成功,在种植体植入前,必须评估骨质量和骨量以及种植体发挥功能的生物力学环境。然而,目前用于即刻种植的传统技术缺乏足够的精确性,通常通过翻开瓣手术来完成。如今,使用立体光刻模板进行计算机引导的无瓣种植手术在临床医生和患者中越来越受欢迎。这种手术方案的优点是微创性、种植体植入的准确性、可预测性、术后不适较少以及确定性修复所需时间减少。数字规划程序的引入使得通过使用预制假体将牙种植体放置在预先规划的位置并即刻进行功能负重成为可能。事实上,手术导板用于制作一个主模型并制作临时桥体,在种植体植入后立即使用引导手术模板将其固定在种植体上。通过这种方式,患者能够在手术当天实现舒适的固定修复,仅需进行 minor occlusal adjustments(此处英文有误,可能是 minor occlusal adjustment,即小的咬合调整)。Job S.等人在三个月的时间里证明,无瓣手术植入种植体周围的牙槽嵴骨高度平均降低(0.06 毫米)无统计学意义,而翻瓣手术植入种植体周围的牙槽嵴骨高度平均降低(0.4 毫米)有统计学意义,得出结论:与无瓣手术相结合使用立体光刻器械可使种植体的即刻植入更具可预测性。然而,该技术在部分修复中的文献记录有限。本文的目的是报告复杂的术前诊断种植体规划和无瓣手术即刻负重方法在部分牙列缺损修复中的益处。