de Lange G L
Academic Center of Oral Implantology, Amstelveen, Nederland.
Int J Dent Symp. 1994;2(1):70-6.
Loss of anterior maxillary teeth always results in bone resorption and loss of interdental papillae, and the resorption makes a single tooth replacement by a dental implant very difficult. When infections have been present and the patient's history shows previous surgery at the apex of the root, bone destruction is substantial, which results in an increased resorption defect, thereby further increasing the aesthetic and prosthetic problems. This paper describes the steps necessary for implant surgery and the prosthetics; a brief summary is provided. The quality and quantity of bone, along with the space available between the adjacent teeth, are the basic factors in treatment planning and determine the type of implant to be used. Some resorption and bone defects are usually present after a tooth extraction, and bone regeneration procedures can be performed either before or simultaneously with the implant placement, with numerous flap designs available. Soft tissue augmentation can be achieved by taking a connective tissue graft from the palatal side. Antirotational devices (eg, hex lock abutments) are necessary for all implants in single tooth replacement. Screw-retained abutments can be used in posterior areas and in angled positions in facial areas as well. With proper single tooth implant position, cementation of laboratory fabricated crowns can be considered.
上颌前牙缺失总会导致骨吸收和龈乳头丧失，而这种吸收使得通过牙种植体进行单颗牙齿替换变得非常困难。当存在感染且患者病史显示牙根尖部曾接受过手术时，骨破坏会很严重，这会导致吸收缺损增加，从而进一步加剧美学和修复问题。本文描述了种植手术和修复所需的步骤，并提供了简要总结。骨的质量和数量，以及相邻牙齿之间的可用间隙，是治疗计划中的基本因素，并决定了所使用种植体的类型。拔牙后通常会出现一些吸收和骨缺损，骨再生程序可以在种植体植入之前或同时进行，有多种瓣设计可供选择。通过从腭侧取结缔组织移植物可以实现软组织增量。单颗牙齿替换中的所有种植体都需要抗旋转装置（例如，六角锁定基台）。螺丝固位基台也可用于后部区域以及面部区域的成角位置。如果单颗牙齿种植体位置合适，可以考虑粘结实验室制作的牙冠。
