- 期刊
拔除阻生贅生齒后立即種植牙科植體合并自體骨移植—病例報告
Immediate Implant Placement and Autogenous Bone Graft after Extraction of Supernumerary Impacted Tooth-Two Cases Report
摘要
上顎前牙區常因吸收造成植牙手術與贗復的挑戰，而根尖部若出現阻生齒，就需考量到是否拔牙、立即或延遲植牙、植 牙的長度、寬度、穩定度與贋復的美觀等因素。傳統的方式爲先予阻生齒拔除，待傷口癒合後再予種入植體。因骨缺損大、瘉恰 的時間較一般拔牙長，患者需容忍較長久之缺虎。本文二病例皆因上顎前牙區缺牙多年，導致骨頭寬度或高度的不足，且缺牙區底下有贅生阻生齒，影響了人工牙根種植的長度。此二病例皆於同一次手術中，將贅生阻生齒拔除後，立即置入15毫米長度的植體合併自體骨移植，重建其根尖骨缺損，及齒槽骨的寬度與高度。雖然手術較複雜，但縮短很多治療時間並提供更佳的贋復功能與美觀。回顧文獻並無類似的報告，因病例特殊，特提出報告，提供植牙的另類模式參考。
並列摘要
Bone resorption of the anterior maxilla is often a problem for both implant surgery and cosmetic result of prosthesis. Given the circumstances of an impacted tooth at the apical region of the anterior maxilla, a few points should be considered, including-whether the impacted tooth should be extracted immediately or not, the length, the width and the stability of the implant, and the appearnaces of the prosthesis. Traditionally, the impacted tooth should be extracted first, and the implant insertion to be performed after the wound is completely healed. Because of larger bony defect and longer healing time, patients would endure longer time of inconuvenienceof tooth loss. The two cases reported here had been edentulous for many years, thus the deficiency in both bone width and height. Both cases were given the circumstances with an impacted tooth in the alveolar ridge of the anterior maxilla which the length of the implants were compromised. In these two cases, immediate implant placement and autogenous bone graft were performed right after extraction of the impacted supernumerary tooth in the same surgical procedures. In spite of the complexity of the surgical procedures, the combination of multiple surgery indeed shorten considerable treatment time and restore the function and cosmetics ad well. There is no similar report in the reviewed literature. As for the particularity of the two cases, they were reported as an additional option for dental implant.