使用数字工作流程在美学区即刻种植与临时修复：一项为期1年的前瞻性病例系列研究。

Immediate Implant Placement and Provisionalization in the Aesthetic Zone Using a Digital Workflow: A 1-Year Prospective Case Series Study.

作者信息

Donker Vincent J J, Raghoebar Gerry M, Vissink Arjan, Meijer Henny J A

机构信息

Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Department of Restorative Dentistry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

出版信息

Clin Implant Dent Relat Res. 2025 Aug;27(4):e70079. doi: 10.1111/cid.70079.

DOI:10.1111/cid.70079

PMID:40707170

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12289460/

Abstract

INTRODUCTION

Immediate implant placement and provisionalization in the maxillary aesthetic zone necessitates meticulous treatment planning. The integration of intraoral scanning with cone beam computed tomography allows for three-dimensional prosthetic-driven planning of the implant. Additionally, it facilitates static computer-assisted implant surgery and prefabrication of a temporary restoration, enabling chairside restoration of the immediate implant. This study aimed to evaluate the clinical, aesthetic, radiographic, and patient-reported outcomes after immediate implant placement and restoration.

MATERIALS AND METHODS

In a prospective case series, 30 patients with a failing tooth in the maxillary aesthetic zone were included and received immediate implant placement with a bone graft and a prefabricated temporary restoration. The definitive restoration was placed 3 months later. The clinical, aesthetic, radiographic, and patient-reported outcomes were collected prior to implant treatment, 6 weeks after the temporary restoration, and 1 month and 1 year after the definitive restoration.

RESULTS

The prefabricated temporary restoration could be placed in all patients. Three cases of early implant failure were observed (implant survival rate 90%); hence, 27 patients were evaluated after 1 year. The survival and success rates were 100% for the temporary and 100% and 96%, respectively, for the definitive restorations. Plaque, bleeding on probing, and peri-implant inflammation were absent in most cases. At the 1-year follow-up, the mean (SD) Pink Esthetic Score and White Esthetic Score (scale 0-20) was 15.4 (2.5). The mean (SD) marginal bone level change between implant placement and the 1-year follow-up was -0.18 mm (0.57) on the mesial side and -0.44 mm (1.23) on the distal side. The median buccal bone thickness remained stable after immediate implant placement and grafting. The mean (SD) patient satisfaction (scale 0-10) was 9.2 (0.8) at the 1-year evaluation.

CONCLUSION

The digital workflow has the potential to enable the manufacture of prefabricated temporary restorations, leading to satisfactory clinical, aesthetic, radiographic, and patient-reported outcomes after immediate placement of single-tooth implants in the aesthetic zone.

CLINICAL TRIAL REGISTRATION

Registered in the National Trial Register (NL8264).

摘要

引言

在上颌美学区即刻种植并进行临时修复需要精心的治疗计划。口内扫描与锥形束计算机断层扫描相结合，可实现基于三维修复的种植体规划。此外，它有助于静态计算机辅助种植手术和临时修复体的预制，从而实现即刻种植的椅旁修复。本研究旨在评估即刻种植与修复后的临床、美学、影像学及患者报告结局。

材料与方法

在一项前瞻性病例系列研究中，纳入30例上颌美学区牙齿缺失的患者，为其即刻种植并植入骨 graft，同时进行预制临时修复。3个月后进行最终修复。在种植治疗前、临时修复后6周、最终修复后1个月和1年收集临床、美学、影像学及患者报告结局。

结果

所有患者均可放置预制临时修复体。观察到3例早期种植失败（种植体存留率90%）；因此，1年后对27例患者进行了评估。临时修复体的存留率和成功率均为100%，最终修复体的存留率和成功率分别为100%和96%。大多数情况下无菌斑、探诊出血和种植体周围炎症。在1年随访时，平均（标准差）粉色美学评分和白色美学评分（0-20分制）为15.4（2.5）。种植体植入至1年随访期间，近中侧平均（标准差）边缘骨水平变化为-0.18 mm（0.57），远中侧为-0.44 mm（1.23）。即刻种植并植骨后，颊侧骨厚度中位数保持稳定。在1年评估时，患者平均（标准差）满意度（0-10分制）为9.2（0.8）。