Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon, Phone: +961 37331173, e-mail:
Department of Prosthodontics and Occlusion, Faculty of Dental Medicine Saint Joseph University, Beirut, Lebanon.
J Contemp Dent Pract. 2024 Mar 19;25(3):213-220. doi: 10.5005/jp-journals-10024-3659.
The objective of this study was to assess marginal bone level around single implants inserted in fresh extraction sockets in the anterior maxillary region and instantly restored with computer-aided design/computer-aided manufacturing customized temporary crowns cemented on the final abutment.
A total of 20 patients (15 females and 5 males, with a mean age of 30 years), where 20 were placed in fresh extraction sockets. After raising a full-thickness flap, atraumatic extraction was performed the implant site was prepared and fixtures were stabilized on the palatal bone wall. The implant location was immediately transmitted to the prepared master model using the pick-up impression coping seated in the surgical guide template. Prefabricated abutments were used as the final abutment on the master model, scanned and the crown was planned using computer-aided manufacturing customized software. Later on 8th weeks, abutments were torqued as per the manufacturer's recommendation, and the final crowns were cemented. Using personalized intraoral radiographs marginal bone level was evaluated mesially and distally to the implant shoulder as a reference at implant placement, 8 weeks, 1, 3, 5, and 10 years after loading.
Wholly implants were osteo-integrated positively after 10 years of practical loading, but only 18 were available for clinical and radiological follow-up, and 2 patients with two implants were excluded from the study due to relocation abroad without any implant failure. The average marginal bone loss (MBL) in the current report was 0.16 ± 0.167 mm at crown cementation, 0.275 ± 0.171 mm after 1 year, 0.265 ± 0.171 mm after 3 years, 0.213 ± 0.185 mm after 5 years, and 0.217 ± 0.194 mm at 10 years.
The strategy of inserting and not removing the final abutment at the time of implant placement facilitates the establishment of adequate attachment of both soft and hard tissues to the abutment surface, ensuring uninterrupted organization of tissue architecture and offers advantages in helping maintain soft tissue maturation and preventing marginal bone level.
Immediately loaded implants in freshly extracted sockets lead to a significant reduction in marginal ridge resorption. The use of a temporary crown on a prefabricated abutment, exclusive of successive abutment manipulation, proved effective in preserving the primarily founding blood clot and served as a prototype for shaping the soft tissue around the previously wounded gum. How to cite this article: Berberi A, El Zoghbi A, Aad G, . Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024;25(3):213-220.
本研究的目的是评估在前上颌区域的新鲜拔牙窝中植入的单颗种植体周围的边缘骨水平,并使用计算机辅助设计/计算机辅助制造定制的临时冠即刻修复,临时冠通过最终基台固定在种植体上。
共有 20 名患者(15 名女性和 5 名男性,平均年龄 30 岁)接受了治疗,其中 20 名患者在新鲜拔牙窝中植入了种植体。在掀起全厚瓣后,进行微创拔牙,在种植部位进行预备,并将种植体固定在腭骨壁上。使用位于手术导板中的取模印模帽,将种植体的位置立即传输到预备的主模型上。在主模型上使用预制基台作为最终基台,对其进行扫描,并使用计算机辅助制造定制软件设计牙冠。8 周后,根据制造商的建议,对基台进行扭矩紧固,并粘结最终牙冠。使用个性化的口腔内射线照相术,在种植体放置、8 周、1 年、3 年、5 年和 10 年后,测量种植体肩台近中和远中边缘骨水平。
10 年实际负载后,所有种植体均实现了骨整合,但只有 18 个可用于临床和影像学随访,由于 2 名患者移居国外且无种植体失败,因此有 2 名患者的 2 个种植体被排除在研究之外。本报告中,牙冠粘结时平均边缘骨损失(MBL)为 0.16±0.167mm,1 年后为 0.275±0.171mm,3 年后为 0.265±0.171mm,5 年后为 0.213±0.185mm,10 年后为 0.217±0.194mm。
在种植体植入时不取出最终基台的策略有利于在基台表面形成足够的软组织和硬组织附着,确保组织结构的连续性,并有助于维持软组织成熟,防止边缘骨水平下降。
即刻负载在新鲜拔牙窝中的种植体可显著减少边缘嵴吸收。使用预制基台上的临时冠,避免了连续的基台操作,这有利于保持最初的血凝块,并作为塑造之前受伤牙龈周围软组织的原型。
Berberi A, El Zoghbi A, Aad G,. 即刻负载使用数字化定制修复在前上颌美学区单个种植体植入的即刻负载:10 年边缘骨水平的前瞻性研究。当代牙科学实践 2024;25(3):213-220.