Grizas Eleftherios, Kourtis Stefanos, Andrikopoulou Efstathia, Romanos Georgios E
Quintessence Int. 2018;49(5):349-364. doi: 10.3290/j.qi.a39820.
Rehabilitation with implants in the esthetic zone is one of the most demanding tasks due to the importance of obtaining an optimum esthetic result. The aim of this article was to present a workflow to create, preserve, transfer and support the emergence profile in anterior maxillary implants. Different methods are used surgically as well as prosthetically to construct an ideal restoration. When immediate loading can be applied in cases of increased primary stability, a provisional restoration is placed with occlusal contacts. In cases not permitting the above procedure and requiring extensive augmentation, a resin-bonded partial coverage fixed partial denture can be a predictable and reliable treatment option until the final restoration is delivered. Creating or preserving the emergence profile at immediate post-extraction and delayed implants, respectively, is achieved through customized provisional, healing abutments, a combination of prefabricated healing abutments and partial coverage provisional restoration, or utilization of the patient's own tooth crown. Transferring the individualized soft tissue contour to the final restoration can be achieved by modifying the impression coping intraorally with composite resin, fabricating a cast mimicking the soft tissue contour in the laboratory, or by the use of CAD/CAM technology. A customized abutment is necessary in order to maintain the emergence profile that has been created during the previous stages. The objective of this paper was to present a detailed workflow for the restoration of anterior maxillary implants focused on the creation, preservation, support, and transfer of the emergence profile of the soft tissues through a series of clinical cases.
由于获得最佳美学效果的重要性，美学区种植体修复是最具挑战性的任务之一。本文的目的是介绍一种在前上颌种植体中创建、保存、转移和支持龈缘轮廓的工作流程。手术和修复过程中会采用不同方法来构建理想的修复体。当在初始稳定性增强的情况下可进行即刻加载时，需放置带有咬合接触的临时修复体。对于不允许上述操作且需要广泛增量的情况，在最终修复体交付之前，树脂粘结局部覆盖固定局部义齿可能是一种可预测且可靠的治疗选择。分别在即刻拔牙后种植体和延期种植体中创建或保存龈缘轮廓，可通过定制临时基台、愈合基台、预制愈合基台与局部覆盖临时修复体的组合，或利用患者自身的牙冠来实现。将个性化的软组织轮廓转移至最终修复体，可通过在口内用复合树脂修改印模帽、在实验室制作模仿软组织轮廓的模型，或使用CAD/CAM技术来实现。为保持在前述阶段创建的龈缘轮廓，定制基台是必要的。本文的目的是通过一系列临床病例，介绍前上颌种植体修复的详细工作流程，重点在于软组织龈缘轮廓的创建、保存、支持和转移。
