Wöhrle Peter S
Private Practice limited to Implant Dentistry and Prosthodontics, Newport Beach, California.
Compend Contin Educ Dent. 2014 Nov-Dec;35(10):758-62, 764-6, 768.
Replacement of multiple adjacent teeth in the esthetic zone with dental implants is a surgical and restorative challenge, especially when an esthetic outcome is essential. Sound diagnosis and treatment planning can be combined with use of cone-beam computed tomography (CBCT) and 3-dimensional (3-D) software to achieve desired results. Placement of implants using guided surgical templates is critical when there is limited space between adjacent teeth or limited bone volume. Slight deviations in implant positioning during placement can lead to implants being too close to adjacent teeth, resulting in bone loss, recession, and encroachment upon adjacent papillae. Placement of implants in anatomically deficient or compromised areas is difficult when using a freehand drill protocol, because attaining the necessary precision cannot be achieved routinely. Esthetically demanding patients require precise implant placement. Use of guided surgical planning and implant placement enables the surgeon to take maximum advantage of available bone in anatomically restricted areas. Restoratively, ideal implant placement facilitates rehabilitation; therefore, all parameters must be observed in order to achieve an esthetically pleasing final restoration.
在美学区域用牙种植体替换多颗相邻牙齿是一项手术和修复方面的挑战，尤其是当美学效果至关重要时。合理的诊断和治疗计划可与锥形束计算机断层扫描（CBCT）及三维（3-D）软件结合使用，以取得理想效果。当相邻牙齿之间空间有限或骨量有限时，使用引导手术模板植入种植体至关重要。植入过程中种植体定位的轻微偏差可能导致种植体过于靠近相邻牙齿，从而导致骨质流失、牙龈退缩以及侵犯相邻牙龈乳头。当使用徒手钻孔方案时，在解剖结构存在缺陷或受损的区域植入种植体很困难，因为常规情况下无法达到所需的精度。对美学要求较高的患者需要精确植入种植体。使用引导手术规划和种植体植入可使外科医生在解剖结构受限的区域最大限度地利用可用骨。在修复方面，理想的种植体植入有利于修复；因此，为了实现美观的最终修复，必须遵守所有参数。
