The Implant and Aesthetic Academy, Cape Town, South Africa.
Medical College of Georgia, University of Pennsylvania, Philadelphia, Augusta, Georgia.
Clin Implant Dent Relat Res. 2018 Apr;20(2):122-129. doi: 10.1111/cid.12554. Epub 2017 Nov 26.
Tooth loss results in an inevitable alveolar ridge reduction. This has established a cautionary approach to extract, wait, augment, and insert the implant, in lieu of immediate placement. However, saving the tooth or part of it whenever possible is more conservative and supports the vital periodontal tissue buccofacial to an implant. The purpose of this cases series was to report on implant survival using this technique in a large cohort of patients at mid-term follow-up.
A private practice patient database was searched for all patients having received socket-shield treatment in conjunction with immediate implant placement. Of the results returned, 128 met the inclusion criteria of ≥12 months from date of restoration, or failing prior to definitive restoration. These patients were recalled for evaluation of the restored implants up to 4 years post-treatment.
Seventy immediate implants with socket-shields were placed in female patients and 58 in males, age range 24-71 (mean 39 years). The distribution of sites treated were: maxillary incisors (64%), premolars (22%), canines (14%); maxilla (89.9%), mandible (10.1%). 123/128 implants osseointegrated and survived 1-4 years following restoration (survival rate 96.1%). A combined complication rate of 25/128 implants occurred (19.5%). Five implants failed to osseointegrate and were removed. The remaining 20 complications were all managed or observed without management, with implants surviving at mid-term follow-up.
Notwithstanding technique sensitivity and the need for randomized control studies, this case series demonstrates that the socket-shield performs competitively when compared to implant survival rates in both conventional immediate and delayed implant placement.
牙齿缺失会导致牙槽嵴不可避免地减少。因此，拔牙、等待、增加牙槽骨量和植入种植体时，应采取谨慎的方法，而不是立即植入。然而，只要有可能，保留牙齿或其部分是更保守的方法，这有利于种植体唇颊侧的牙周组织的存活。本病例系列报告的目的是在中期随访中，报告使用这种技术的大量患者的种植体存活率。
在私人执业患者数据库中，搜索了所有接受牙槽窝保护并立即植入种植体的患者。在返回的结果中，有 128 名患者符合纳入标准，即从修复日期起至少 12 个月，或在最终修复前失败。这些患者在治疗后 4 年内被召回评估修复后的种植体。
70 个带有牙槽窝保护的即刻种植体被植入女性患者中，58 个植入男性患者中，年龄范围 24-71 岁（平均 39 岁）。治疗部位的分布为：上颌切牙（64%）、前磨牙（22%）、尖牙（14%）；上颌（89.9%）、下颌（10.1%）。123/128 个种植体在修复后 1-4 年内实现了骨整合并存活（存活率为 96.1%）。128 个种植体中有 25 个（19.5%）发生了联合并发症。5 个种植体未实现骨整合并被取出。其余 20 个并发症均未处理或观察，种植体在中期随访中存活。
尽管技术敏感性和需要进行随机对照研究，但本病例系列表明，与传统即刻和延迟种植体植入的种植体存活率相比，牙槽窝保护技术具有竞争力。
