Wei D H, Zhao Y J, Di P, Tian J H, Jiang X, Lin Y
Department of Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Center of Digital Dentistry, Faculty of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2019 Jan 9;54(1):3-9. doi: 10.3760/cma.j.issn.1002-0098.2019.01.002.
To establish a quantitative three-dimensional method based on intraoral scan and apply it to evaluation of the facial soft tissue contour alterations following single immediate implant and immediate provisionalization (IIPP) in central incisor via intraoral scanning. This study was a prospective clinical study. The trial was conducted at Department of Implantology, Peking University School and Hospital of Stomatology, from January 2016 to September 2017. Twenty-nine eligible consecutive patients (15 women, 14 men) with a mean age of (34.3±12.0) were included and received immediate replacement of the failure maxillary single central incisor. A screw-retained immediate restoration was delivered for each patient. At 6-month follow-up, impression was taken and a screw-retained permanent restoration was performed for each patient. The anterior maxillary region was scanned by an intraoral scanning system at pre-surgery and 1-year follow-up. The Standard Tessellation Language (STL) files were output to a dedicated software and superimposed. Mid-facial recession and gingival zenith symmetry at 1-year follow-up were measured in the digital models. Three-dimensional configurations of the contour change volume were calculated and reconstructed for visual analysis. Furthermore, the following parameters were used to analyze the reconstructed volume: mean contour change in thickness (△d), mesio-distal width (D(W)), coronal-apical height (D(H)), contour change at 0, 1, 2, 3, 4, 5 mm apical to the free gingival margin on the implant site. Twenty-seven out of twenty-nine enrolled patients were finally available for analysis. At 1-year follow-up, the mid-facial mucosa level at implant site was (0.23±0.39) mm apical to the gingival zenith of the contralateral tooth. In general, a contour collapse was found in every patient. △d, D(W) and D(H) of the collapsed volume were (0.62±0.22), (11.03±1.74) and (6.82±1.52) mm, respectively. Contour change at 0, 1, 2, 3, 4, 5 mm apical to the free gingival margin on the implant site were (0.54±0.48), (0.87±0.62), (1.03±0.46), (0.96±0.52), (0.90±0.52), (0.89±0.57) mm. The described quantitative measurement based on intraoral scan can be an effective method for assessment of soft tissue contour changes. At 1 year following single IIPP treatment in maxillary incisor, free gingival margin is stable, with only mild recession. The mean level of the facial soft tissue contour collapse is 0.62 mm.
建立基于口内扫描的定量三维方法,并将其应用于通过口内扫描评估上颌中切牙单颗即刻种植与即刻临时修复(IIPP)后面部软组织轮廓的改变。本研究为前瞻性临床研究。试验于2016年1月至2017年9月在北京大学口腔医学院·口腔医院种植科进行。纳入29例符合条件的连续患者(15例女性,14例男性),平均年龄(34.3±12.0)岁,接受上颌单颗中央切牙失败后的即刻种植修复。为每位患者提供螺丝固位的即刻修复体。在6个月随访时,取印模并为每位患者进行螺丝固位的永久修复。术前及1年随访时,使用口内扫描系统对上颌前部区域进行扫描。将标准三角面片语言(STL)文件输出到专用软件并进行叠加。在数字模型中测量1年随访时的面部中部凹陷和牙龈顶点对称性。计算并重建轮廓变化体积的三维构型以进行视觉分析。此外,使用以下参数分析重建体积:厚度的平均轮廓变化(△d)、近远中宽度(D(W))、冠根高度(D(H))、种植位点游离龈缘根尖向0、1、2、3、4、5 mm处的轮廓变化。29例纳入患者中,最终27例可用于分析。1年随访时,种植位点面部中部黏膜水平相对于对侧牙牙龈顶点根尖向移位(0.23±0.39)mm。总体而言,每位患者均出现轮廓塌陷。塌陷体积的△d、D(W)和D(H)分别为(0.62±0.22)、(11.03±1.74)和(6.82±1.52)mm。种植位点游离龈缘根尖向0、1、2、3、4、5 mm处的轮廓变化分别为(0.54±0.48)、(0.87±0.62)、(1.03±0.46)、(0.96±0.52)、(0.90±0.52)、(0.89±0.57)mm。所描述的基于口内扫描的定量测量方法可作为评估软组织轮廓变化的有效方法。上颌中切牙单颗IIPP治疗后1年,游离龈缘稳定,仅有轻度退缩。面部软组织轮廓塌陷的平均水平为0.62 mm。