Bender M F
University of Pittsburgh, USA.
Int J Dent Symp. 1994;2(1):65-9.
Up to the present time, the discussions of single crown restorations with dental implants have been focused primarily on the anterior maxilla or mandible. This clinical case presentation illustrates that it is possible to reconstruct the posterior mandible, and, for the first time, even the subantral augmented maxilla after sinus elevation, with single crowns supported by implants. The presented treatment philosophy imitates natural human dentition. After a single tooth loss, an implant is placed immediately in order to provide functional stimulation of the bone, thereby maintaining the activity of the osteoblasts and keeping the alveole bone is sound condition due to the natural function. After extensive bone augmentation, reconstruction, proper healing time, and precise prosthetic planning of the optimal location of the crowns, implants were placed accordingly and later restored with single crowns in the size of premolars. According to the natural dentition, the author placed one implant per molar root, ie, one implant each for the mesial and distal root of the first molar and possibly the mesial root of the second molar. In all the cases restored, the crown/root ratio was smaller than one. The size of the crown is designed in such a way that the masticatory forces are transmitted axially and vertically via crown into the implant. In 16 clinical cases, none of the 96 single crowns and implants (28 of these in the augmented subantral region of the maxilla), have been lost during 6 months to 3 years of use.
到目前为止，关于牙种植单冠修复的讨论主要集中在上颌或下颌前部。本临床病例展示表明，通过种植体支持的单冠修复，有可能重建下颌后部，甚至首次在窦提升后的上颌窦下增高区域进行修复。所呈现的治疗理念模仿天然人类牙列。单颗牙齿缺失后，立即植入种植体以提供对骨的功能刺激，从而维持成骨细胞的活性，并由于自然功能使牙槽骨保持健康状态。在进行广泛的骨增量、重建、适当的愈合时间以及对冠的最佳位置进行精确的修复计划后，相应地植入种植体，随后用前磨牙大小的单冠进行修复。根据天然牙列，作者在每颗磨牙牙根处植入一颗种植体，即第一磨牙的近中根和远中根各植入一颗种植体，可能第二磨牙的近中根也植入一颗。在所有修复的病例中，冠根比均小于1。冠的尺寸设计成咀嚼力通过冠轴向和垂直地传递到种植体中。在16个临床病例中，96颗单冠和种植体（其中28颗在上颌窦下增高区域）在使用6个月至3年期间均未丢失。
