Jones Andoni
Int J Esthet Dent. 2019;14(3):334-344.
Implants in the esthetic zone can be challenging due to the buccal plate resorption that occurs after tooth extraction. The socket shield technique has proven to maintain the buccal bone and midfacial tissue, minimizing the risk of tissue loss that can lead to an unesthetic emergence of the implant restoration. The socket shield technique is, however, a technically difficult procedure to perform. Key aspects for achieving a successful treatment outcome are a careful extraction of the palatal portion of the root, a meticulous buccal shield preparation, and accurate implant drilling and placement. A flapless approach has been described classically in the postextraction socket shield implant scenario. This case report describes an immediate implant in the maxillary right central incisor on a patient with a high lip line and exacting cosmetic demands. An open flap approach to improve the visibility of the partial extraction and to minimize potential complications derived from an inadequate shield preparation is described. No adverse effects such as soft tissue scarring were visible after 1 year of loading, and tissue volume, color, and contour were maintained during the observation period.
由于拔牙后会发生颊侧骨板吸收，美学区域的种植体植入颇具挑战性。牙槽窝屏障技术已被证明可维持颊侧骨和面部中部组织，将可能导致种植体修复体出现不美观的组织丧失风险降至最低。然而，牙槽窝屏障技术是一项操作难度较大的手术。实现成功治疗效果的关键因素包括小心拔除牙根的腭侧部分、精心制备颊侧屏障以及精确的种植体钻孔和植入。在拔牙后牙槽窝屏障种植的情况下，经典的描述是采用无瓣法。本病例报告描述了一位唇线较高且对美观要求苛刻的患者上颌右侧中切牙的即刻种植。文中描述了一种开放瓣法，以提高部分拔牙的可视性，并将因屏障制备不足而产生的潜在并发症降至最低。负重1年后未见软组织瘢痕等不良反应，观察期内组织体积、颜色和轮廓得以维持。
