Schwartz-Arad D, Chaushu G
Department of Oral and Maxillofacial Surgery, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Israel.
J Periodontol. 1997 Oct;68(10):915-23. doi: 10.1902/jop.1997.68.10.915.
A waiting period of 12 months or longer to allow total socket healing used to be accepted protocol for placing dental implants. More than 15 years of research and clinical practice were needed for the concept of immediate endossceous implantation into fresh extraction sites to be accepted. Today the dilemma is no longer when, but which, protocol to follow. The diverse recommendations found in the literature leave the practitioner confused as to the methodology of choice. The conclusions drawn after reviewing the relevant literature on immediate dental implantation are: 1) implants placed into fresh extraction sockets have a high rate of survival, ranging between 93.9% to 100%; 2) implants must be placed 3 to 5 mm beyond the apex in order to gain a maximal degree of stability; 3) implants should be placed as close as possible to the alveolar crest level (0 to 3 mm); 4) there is no consensus regarding the need for gap filling and the best grafting material; 5) the use of membrane does not imply better results-on the contrary, membrane exposure may carry complications in its wake; and 6) the absolute need for primary closure remains to be established.
过去，等待12个月或更长时间以使牙槽窝完全愈合是植入牙种植体的公认方案。将即刻骨内种植体植入新鲜拔牙位点的概念被接受需要15年以上的研究和临床实践。如今，困境不再是何时进行，而是遵循哪种方案。文献中发现的各种建议让从业者对选择的方法感到困惑。在回顾了关于即刻牙种植的相关文献后得出的结论是：1）植入新鲜拔牙窝的种植体有很高的存活率，在93.9%至100%之间；2）种植体必须放置在根尖以外3至5毫米处，以获得最大程度的稳定性；3）种植体应尽可能靠近牙槽嵴水平（0至3毫米）；4）关于是否需要间隙填充和最佳移植材料尚无共识；5）使用膜并不意味着会有更好的结果——相反，膜暴露可能会带来并发症；6）是否绝对需要一期缝合仍有待确定。
