- 期刊
即拔即植合併Socket Shield Technique技術應用在前牙美觀區案例報告
Immediate Implant with Socket-Shield Technique in the Anterior Esthetic Area: Case Series
摘要
研究目的：研究目的：拔牙後半年內伴隨齒槽骨嚴重吸收，尤其是前牙頰側骨厚度小於1 mm且牙齦生物型態較薄（thin biotype）時，對於植牙美學來說是個挑戰。Hürzeler等學者（2010）發表新的術式“socket-shield technique”，藉由留下部分頰側牙根、保留頰側骨板內的牙周韌帶，以不破壞血供下減少骨吸收。然而，相關的文獻報告仍較少。本篇目的在於呈現及討論單顆前牙頰側骨板較薄的殘根，以socket-shield technique即拔即植，並以濃縮生長因子關閉齒槽窩洞的應用。材料與方法：本篇三個案例，皆是單顆上顎側門齒殘根頰側骨壁小於1 mm，以即拔即植socket-shield technique術式，前兩例應用血液離心技術合併骨粉填滿植體與牙根片之間的縫隙，第三個案例則將濃縮生長因子改以膠原蛋白取代。結果：即拔即植合併socket-shield technique應用在單顆前牙，軟硬組織完整且美觀效果佳。術後1－2年半CBCT顯示頰側骨厚度維持2 mm以及咬合功能良好。侵入性低的情況下完成微創植牙，達到醫病皆滿意的成果。結論：即拔即植合併socket-shield technique應用在前牙植牙有許多優勢，特別針對頰側骨板較薄的情況。或許可成為前牙美學植牙術式的選項之一，但仍然需長期追蹤和累積較大樣本數、具有對照組的臨床試驗來支持此術式。
並列摘要
Purpose: Previous studies prescribed that the severe bone resorption usually occurred 6 months of post-extraction. This phenomenon is more pronounced in the anterior area which thinner buccal plate < 1 mm thin biotype. Consequently, the placement of implant in esthetic areas becomes a challenge. Hürzeler et.al 2010 published a new technique termed " socket-shield technique ", leaving a part of root on the buccal side, thereby maintaining healthy periodontium, preserving soft tissue and blood supply. However, relevant literature reports remain scarce. The aim of this report is to present and discuss the anterior teeth with thinner buccal plate by using socket-shield technique with immediate implant placement and concentrated growth factor (CGF) or collagen used for socket sealing. Materials & Methods: A total of three patients who had residual root of lateral incisor due to fracture and buccal plate < 1 mm, had undergone immediate implant with socket-shield technique. Both case (1) and (2) used concentrated growth factors (CGF) and bone grafts to fill the gap between buccal plate and implant. However, in case (3), collagen used as an alternative to CGF. Results: Socket-shield technique in immediate implant at anterior single teeth rehabilitation, effectively retain the buccal plate (2 mm thick showed in CBCT). Both soft and hard tissues surrounding the implant exhibit healthy and stable throughout the 1-2 years of follow-up, achieving aesthetic outcomes with minimal invasive method that both patients and doctors are satisfied. Conclusion: Retaining the part of the root during immediate implant in the anterior area, offers benefits, especially in thinner buccal plate < 1 mm. At present, specialized instrument kits introduced to minimize technique sensitive. However, extensive clinical trials for long-term follow-up are imperative to further elucidate the efficacy of this technique.