Alrmali Abdusalam, Stuhr Sandra, Saleh Muhammad H A, Latimer Jessica, Kan Joseph, Tarnow Dennis P, Wang Hom-Lay
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Department of Oral Pathology, Oral Medicine and Oral & Maxillofacial Surgery, University of Tripoli, School of Dentistry, Tripoli, Libya.
J Esthet Restor Dent. 2023 Dec;35(8):1239-1248. doi: 10.1111/jerd.13100. Epub 2023 Jul 14.
To develop a comprehensive decision-making tree for evaluating mid-facial peri-implant soft tissue dehiscence in the esthetic zone and provide a systematic approach for assessing various clinical case scenarios, determining appropriate treatment strategies, and considering factors such as the need for soft tissue augmentation, prosthetic changes, or implant removal.
This clinical decision tree illustrates numerous case scenarios with various esthetic complications around an esthetically compromised, but clinically healthy single implant and provides clinicians with possible solutions as a predictable map for horizontal and vertical soft tissue augmentation in order to manage different clinical circumstances. According to current evidence, the key to treating such esthetic complications is the use of an adequate pre-surgical prosthetic interdisciplinary approach with proper surgical techniques in order to optimize soft tissue dimensions and create better esthetic results. This may be accomplished through a purely surgical, combination of surgical and prosthetic, or purely prosthetic approaches.
The present report describes a series of successfully treated peri-implant esthetic complication cases in accordance with the decision-making tree that the authors recommend in order to achieve better long-term esthetic outcomes.
The combination of adequate pre-surgical prosthetic interdisciplinary collaboration and proper surgical technique is critical in the optimization of sufficient soft tissue dimensions and contributes to a more highly esthetic result. This study demonstrates a clinical decision-making tree to provide comprehensive, effective therapy of an esthetically compromised dental implant by using one of the following approaches: purely prosthetic, purely surgical, or a combination of surgical and prosthetic with or without abutment removal.
制定一个综合决策树，用于评估美学区域种植体周围软组织裂开情况，并提供一种系统方法，以评估各种临床病例情况，确定合适的治疗策略，同时考虑诸如软组织增量需求、修复体改变或种植体移除等因素。
本临床决策树展示了围绕一枚美学效果欠佳但临床健康的单颗种植体出现各种美学并发症的众多病例情况，并为临床医生提供了可能的解决方案，作为水平和垂直软组织增量的可预测图谱，以便应对不同的临床情况。根据现有证据，治疗此类美学并发症的关键在于术前采用充分的修复跨学科方法并结合适当的手术技术，以优化软组织尺寸并获得更好的美学效果。这可以通过单纯手术、手术与修复相结合或单纯修复的方法来实现。
本报告描述了一系列按照作者推荐的决策树成功治疗的种植体周围美学并发症病例，以实现更好的长期美学效果。
充分的术前修复跨学科协作与适当的手术技术相结合，对于优化足够的软组织尺寸至关重要，并有助于获得更高的美学效果。本研究展示了一种临床决策树，通过以下方法之一为美学效果欠佳的牙种植体提供全面、有效的治疗：单纯修复、单纯手术，或手术与修复相结合（有无基台移除）。
