平台轉移的概念：文獻回顧與病例報告

The concept of platform switching: Literature review and a case report

鄭智文(Chih-Wen Cheng) ； 簡佳慧(Chia-Hu i Chien) ； 陳俊榮(Chun-1ung Chen) ； 曾春祺(Chuen-Chyi Tseng) ； 彭玉秋(lok-Chao Pang)

《臺灣牙周病醫學會雜誌》 16卷3期 (2011/09) Pp. 161-174

摘要

由於植體表面處理與手術技術的進步，成功的骨整合（osseointegration）已成為最基本的要求，理想的美觀漸漸成為共同追求的目標，然而前牙區植牙要達到美觀，植體周圍骨頭的條件是相當重要的因素，但是傳統二階段式的植體（two-piece implants）往往會導致早期植體周圍骨喪失（earl y periimplant bone loss）若植牙的位置較不理想，便可能產生牙海萎縮、牙乳突（dentalpapilla）缺失等問題：而平台轉移（platform switching）的植體設計被認為能避免減少植體周圍骨喪失，維持植體周圍軟組織的穩定，對於美觀有相當大的幫助。本病例報告為一女性患者因# 11深度齲齒而需要拔除，牙齒拔除七周後在# 11缺牙區植入新型的平台轉移式植體（Straumann® Bonel Level Implant），手術五個月後完成單顆義齒的製作，唇側牙齦的位置與鄰牙一致，且牙乳突也充滿了齒間縫隙，根尖片也顯示並無明顯的植體周圍骨喪失，手術後37.5 個月植體-骨附連（first bone-to-implant contact）停留在植體平台處，植體周圍軟組織也相當穩定。（台灣牙周醫誌16: 161-174, 2011）

關鍵字

平台轉移 ； 早期植體周圍骨喪失 ； 微縫隙 ； 生物性寬度

並列摘要

Due to the advancement of implant surface treatment and the technique of implant surgery, a successful osseointegration has become a basic requirement in the anterior maxilla. Conversely, an ideal esthetic result has become the main treatment goal. The periimplant bone condition is the critical factor to the esthetic outcome. However, early periimplant bone loss around the two-piece implant will inevitably occur following implant placement, which may leads to compromised esthetic result due to mucosa recession or papilla loss. In accordance with the Iiterature review, implant-abutment connection with the platform-witching design may preserve periimplant bone height and soft tissue level. This design may be beneficial to esthetic result. The case reports a female who came for help because of a sinus tract on the labial gingiva of R't maxillary centra l incisor. After clinical and radiographic examinations, the prognosis of R't central incisor was hopeless due to insufficient tooth structure. The tooth was extracted atraumatically and an implant with platform switching design (Straumann® Bone Level Implant) was placed 7 weeks after tooth extraction . 5 months later, a screw-retained single crown was delivered, and no obvious periimplant bone loss could be found. 37.5 months after implant placement, there was no mucosal recession or papilla loss, and periapical radiograph showed that the first bone-to-implant contact was maintained at implant platform.（J Taiwan Periodontol16: 161-174, 2011）

並列關鍵字

Platform switching ； early periimplant bone　loss ； microgap ； biologic width