A Preliminary Clinical Study of Buccal Bone Alteration Using the Socket-Shield Technique and Immediate Implant Placement

利用齒槽盾牌術進行立即植牙後之頰側骨變化量：初步臨床研究

陳維筑(Wei-Chu Chen) ； 陳智龍(Chih-long Chen)

《臺灣牙周病醫學會雜誌》 21卷2期 (2016/06) Pp. 137-145

https://doi.org/10.6121/TAP.2016.21.2.03

摘要

臨床醫師在拔牙後常會面臨的主要問題是水平及垂直方向的頰側骨吸收。基於美觀考量，有文獻提出保留部分牙根可以避免拔牙後的軟硬組織變化。根據2010年Huerzeler等人提出的齒槽盾牌術，就是在拔牙時將頰側牙根保留，之後進行立即植牙。本文提出4個案例，分別在上顎側門齒及小臼齒區域施行齒槽盾牌術合併立即植牙。等待3個月後，臨床檢查可見穩定的植牙旁軟組織及頰側骨平均水平吸收量為0.83 ± 0.178 mm，因為數值極小，為臨床上可忽略的變化。之後植牙的贋復物也成功地恢復病人的咀嚼功能及美觀。

關鍵字

齒槽盾牌術 ； 立即植牙 ； 齒槽脊保留

並列摘要

A major problem that a clinician encounters is the resorption of buccal tissues in horizontal and vertical directions after tooth extraction. Due to this esthetic concern, it has been assumed that retaining a root fragment attached to the buccal bone plate will avoid tissue alteration after tooth removal. The socket-shield technique, a recently proof-of-principle experiment published by Huerzeler et al. in 2010, involved leaving a part of the root on the buccal side and this was done in conjunction with immediate implant placement; we applied this approach with our cases. This article consists of four cases, each of which had a failing upper lateral incisor and premolar, these were replaced with an implant that was inserted in accordance with the socket-shield technique. Three months after implant placement, clinical examinations showed healthy peri-implant soft tissue with the average amount of horizontal resorption at the buccal side being only 0.83 ± 0.178 mm, which is clinical negligible. The prostheses were also able to successfully restore patient functionality. It may be concluded that ＂socket-shield technique,＂ where there is retention of the buccal aspect of the root in conjunction with immediate implant placement, is a predictable technique that is able to achieve osseointegration without any inflammatory or resorptive response. Furthermore, this approach also helps to prevent resorption of buccal tissue after tooth extraction.

並列關鍵字

socket-shield technique ； immediate implant ； ridge preservation