Department of Surgical, Medical, Molecular Pathology and of the Critical Area, University of Pisa, 56126 Pisa, Italy.
Dental Biomaterials Research Unit, University of Liege, 4020 Liege, Belgium.
Medicina (Kaunas). 2024 Nov 1;60(11):1786. doi: 10.3390/medicina60111786.
This study aimed to describe a case of simultaneous guided bone regeneration (GBR) and implant placement in a patient with prior aesthetic implant failure, focusing on achieving optimal aesthetic and functional outcomes, and to perform a literature review of the current evidence. A 38-year-old male presented with an improperly positioned implant at the level of the right upper central (tooth 2.1), leading to aesthetic and functional issues. The initial assessment included a panoramic radiograph revealing marginal bone loss and an enlarged peri-implant space, necessitating implant removal. Following implant removal and provisional restoration, the patient was re-evaluated for subsequent therapeutic treatments. The patient underwent orthodontic treatment to improve mesio-distal spacing, followed by surgical intervention involving GBR and simultaneous implant placement. The GBR procedure utilised bone substitutes and resorbable membranes, with soft tissue augmentation conducted subsequently. The surgical intervention involved local anaesthesia, flap design, defect assessment, and palatally oriented implant placement. GBR was then performed. After six months, implant uncovering and soft tissue augmentation were conducted. The implant was loaded with a screwed restoration following complete hard and soft tissue healing. The patient was monitored every six months for two years, then annually. At the 10-year follow-up, no signs of bone resorption or soft tissue inflammation were observed. This case demonstrated that GBR and simultaneous implant placement, with the application of advanced biomaterials, effectively promoted osseointegration and maintained aesthetic and functional stability over a decade.
本研究旨在描述一例同时进行引导骨再生（GBR）和种植体植入的病例，该病例患者先前的美学种植体失败，重点是实现最佳的美学和功能效果，并对当前的证据进行文献回顾。一名 38 岁男性因右上中（2.1 号牙）位置不当的植入物出现美学和功能问题就诊。初始评估包括全景片显示边缘骨丧失和种植体周围空间增大，需要取出植入物。在取出植入物和临时修复后，对患者进行了后续治疗的重新评估。患者接受了正畸治疗以改善近远中间距，然后进行了涉及 GBR 和同期种植体植入的手术干预。GBR 手术使用了骨替代物和可吸收膜，随后进行了软组织增强。手术干预包括局部麻醉、瓣设计、缺损评估和腭向植入物放置。然后进行了 GBR。六个月后，进行了种植体暴露和软组织增强。在完全硬组织和软组织愈合后，用螺丝固定修复体加载植入物。患者每六个月监测一次，持续两年，然后每年监测一次。在 10 年的随访中，未观察到骨吸收或软组织炎症的迹象。该病例表明，GBR 和同期种植体植入，应用先进的生物材料，有效地促进了骨整合，并在十年内保持了美学和功能的稳定性。
