Zhang Y, Lin Y, Liu Y, Luo J, Di P, Ma T
Department of Implantology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Department of Orthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2017 Oct 9;52(10):625-630. doi: 10.3760/cma.j.issn.1002-0098.2017.10.009.
To investigate the changes of the lateral cephelometric landmarks of soft tissue and hard tissue of patients with maxillary alveolar protrusion and advanced periodontitis treated with immediate implants and cross-arch fixed prostheses. From January 2013 to October 2016, consecutive patients with advanced periodontitis and maxillary alveolar protrusion in need of immediate implants and cross-arch fixed prostheses were included in this study. All the patients were treated with provisional cross-arch fixed prostheses supported with 4 to 6 immediate implants after extraction of all the residual teeth and reduction of excessive alveolar bone. After 6 months, a final cross-arch fixed prosthesis was delivered. The lateral cephalometric landmarks of soft tissue and hard tissue at the time of pre-operation and final prosthesis delivery were analyzed. The change of patients facial aesthetics was assessed using visual analogue scale (VAS). Ten patients were included in the study. All the patients underwent full arch rehabilitation of both jaws supported by a total of 89 dental implants. In the maxillae, the average number of inserted implants were 4.5. The mean height of alveolar bone reduction was (6.3±1.8) mm. Both the distance of U1-NA (the upper incisor to nasion-A point line) and U1-PP (the upper incisor to palatal plane) were significantly reduced by (5.5±2.7) mm and (1.6±1.2) mm, respectively. The angle of U1-SN (between upper incisor to sella-nasion line) was reduced by 9.6°±8.1°palatally. The nasolabial angles were significantly increased by 10.5°±6.4°. Both the patients and dentists considered that the facial aesthetics was improved greatly after the treatment. With the reduction of excessive alveolar bone and the realignment of artificial teeth, the treatment of immediate implants and cross-arch fixed prostheses could improve the facial aesthetics of the patients with advanced periodontitis and maxillary alveolar protrusion.
探讨即刻种植联合跨牙弓固定修复治疗上颌牙槽突前突伴重度牙周炎患者软硬组织侧位头影测量标志点的变化。2013年1月至2016年10月,本研究纳入连续的需要即刻种植联合跨牙弓固定修复的重度牙周炎伴上颌牙槽突前突患者。所有患者在拔除所有残牙并减少过多牙槽骨后,采用4至6枚即刻种植体支持的临时跨牙弓固定修复体进行治疗。6个月后,交付最终的跨牙弓固定修复体。分析术前和最终修复体交付时软硬组织的侧位头影测量标志点。使用视觉模拟量表(VAS)评估患者面部美观度的变化。本研究纳入10例患者。所有患者均接受了全牙弓修复,上下颌共植入89枚种植体。在上颌,平均植入种植体数量为4.5枚。牙槽骨减少的平均高度为(6.3±1.8)mm。U1-NA(上前牙至鼻根点-A点连线)和U1-PP(上前牙至腭平面)的距离分别显著减少了(5.5±2.7)mm和(1.6±1.2)mm。U1-SN(上前牙至蝶鞍-鼻根连线)角腭向减少了9.6°±8.1°。鼻唇角显著增加了10.5°±6.4°。患者和牙医均认为治疗后面部美观度有显著改善。通过减少过多的牙槽骨和重新排列人工牙,即刻种植联合跨牙弓固定修复治疗可改善重度牙周炎伴上颌牙槽突前突患者的面部美观度。