【摘要】 目的:对上前牙美学区种植义齿的方法和问题进行讨论。方法:选取种植修复后3-5年的病例随访分析检查。患者计58人,男:39;女:17。年龄:24～60岁。其中涉及骨增量者达90%以上,多数病例进行了局部软组织处理。治疗前后均有X光检查记录。外伤患者多即拔即种,骨缺损明显则先期补骨或种植同时进行骨增量。失牙原因为外伤、重龋、正畸相关、牙周病等。修复时除常用美学基台外还采用瓷基台和个性化基台。无论外科处理还是修复方式多采用不同方法相互配合。结果:一例onlay植骨出现软组织张力大移植骨少量暴露致部分骨坏死影响了修复完美,一例因软组织愈合欠佳导致龈乳头退缩,患者不接受软组织成型术,虽采用牙龈瓷弥补美观效果仍欠缺。其余均达到满意效果。结论:恢复前牙缺失的功能与美观是种植修复的热点和难点,把握适应症及种植与修复时机,改善软硬组织质量并完善修复技术可以获得满意的美学效果。更多还原

【Abstract】 Objective: The clinical applications and problematic solutions for the implant support restorations at anterior maxillary esthetic zone.Method: Totally 58 patients ages range from 24 to 60 were followed for 3-5 years (Male: 39 Female: 17) .The reasons of teeth missing caused by trauma,severe caries,orthodontics reasons and periodontal disease.90% of patients had bone augmentation and most of them received local soft tissue management.The radiographic examinations were given for pre- and post-operation.The most of traumatic cases received immediate implant.The patients who had severe bony defect received bone augmentation prior or during the implant operation.Esthetic,ceramic or custom abutments were fabricated in order to get proper aesthetic results..Combination of clinical technical methods were applied for both surgical and restorative phases in order to achieve satisfactory cosmetic outcomes.Result: One onlay bone grafted case had lack esthetic appearances due to excessive soft tissue tension that resulted partial bony exposure and necrosis.One case had gingival papillae recession because of poor soft tissue healing.Due to patient refused to receive the secondary soft tissue graft.,the esthetic appearance was compromised although gingival porcelain was adopted.The other cases are obtained satisfactory clinical outcomes.Conclusion: Implant supported restorations at maxillary cosmetic zone achieve good esthetic appearances are still great challenges.Having good indications,improve hard and soft tissue qualities,proper time for the implant surgery and restoration phases and good prosthetic techniques can obtain satisfactory results.更多还原