外伤性牙缺失种植美学修复序列治疗研究.docVIP

外伤性牙缺失种植美学修复序列治疗研究 　　[摘要]目的：观察美学区外伤性牙缺失种植美学修复序列治疗的临床效果。方法：美学区外伤性牙缺失患者18例，共植入种植体32枚。在种植修复的不同阶段分别采用骨引导再生技术（guided bone regeneration GBR）、软组织成型技术（sculpting soft tissue）等手段进行软硬组织增量、临时修复体对软组织进行干预塑型，应用个性化取模技术进行永久修复。在各阶段通过软组织美学指数（pink esthetic score，PES）4项主要评分对软组织进行美学评价。结果：所有种植体均发生骨结合，临时修复体挤压塑型的牙龈外形良好，永久修复体戴入后的PES平均得分为（6.59±0.67）分，高于手术前PES平均得分（4.96±0.89）分，评分经t检验显示有统计学差异（P0.05）。患者对永久修复效果满意。结论：采用种植美学序列治疗对外伤性缺失牙进行修复的美学效果可靠，是一种良好的修复方法。 　　[关键词]牙外伤；美学修复；序列治疗 　　[中图分类号]R783 [文献标识码]A [文章编号]1008-6455（2015）09-0053-05 　　Abstract： Objective To observe the clinical effects of dental implants in the aesthetic restoration of traumatic dentition defect patients caused by serious trauma. Methods 32 commonly used implants were inserted in 18 patients with dentition in aesthetic area.In the process of treatment many kinds of methods are used such as GBR，sculpting soft tissue by combine adhensive fixed partial denture and implant-supported temporary restoration. Using custom-made transfer coping to give technician precise soft tissue information.Soft tissue esthetic condition was evaluated through 4 main index reference pink esthetic score（PES）during the process of treatment. Results All the implants were survival.The index of the mean PES was 6.59±0.67 that higher then（4.96±0.89）which was the mean PES of previous phase.There were significant differences（P0.05）.Patients were satisfied with the clinical results. Conclusion The clinical effects of dental implants in the aesthetic restoration of traumatic dentition defect patients caused by serious trauma was good method. 　　Key words：dential implantation；aesthetic restoration；sequential therapy 　　近年来，种植义齿修复技术日趋成熟，已成为外伤性牙列缺损固定修复的最佳手段之一[1]。然而随着口腔种植医学的不断成熟与发展，人们已不再仅仅满足于种植体的存留率与功能，而是更加关注自然美观的修复效果[2]。对于美学区的种植修复，为达到理想的美学修复效果，序列治疗的理念显得尤为重要。从详细的术前检查、风险评估、治疗方案的设计及确定、必要的基础治疗、手术实施、临时修复、永久修复到定期复查维护，各个环节环环相扣，紧密相连。只有综合利用多种技术，才能达到自然美观的修复效果[3]。 　　1 资料和方法 　　1.1一般资料 　　2010-2014年在我科就诊的前牙区外伤性牙缺失患者18例（男11例，女7例），年龄18～42岁，平均年龄29.4岁。牙齿连续缺失2颗及以上者7例，均伴有一定程度的骨缺损；