下颌第一磨牙拔牙后即刻种植的临床观察

摘要

Objective To evaluate the clinical efficacy of immediate implant after extraction of the mandibular first molar . Methods After minimally-invasive tooth extraction of the mandibular first molar of 23 patients, Nobel Replace root form implants were implanted and the torque values were recorded when the implants were in place completely ; bone substitute material and collagen membrane were used to complete the processing of bone defects around the implants ;a wide-neck healing abutment was installed and an open mode of healing was used;stitches were taken out in 10 d after the implantation , further consultation with doctors were made in one month, three months, and six months, and the upper structure repair was completed after six months;and then, follow-up was made for three months .The state of soft tissue in the implanted area and the stability of the healing abutment were recorded , and the masticatory function after repair was evaluated .Results When the 23 implants were implanted , the average torque value was (38.90 ± 10.97)N· cm;the gingival tissue around the healing abutment was getting stable within 1-2 w after the operation;in six months after the operation, the epithelial cuff was formed around the healing abutment , and this met the requirements for biologic closure of soft tissue.After the repair, normal masticatory function was restored .Conclusion Strict control of indications can ensure that the immediate implant of mandibular first molar can obtain good initial stability and repair effect ; in the mandibular first molar area , a wide-neck healing abutment for open healing can get good effect of soft tissue closure and soft tissue healing .%目的：评价下颌第一磨牙拔牙后即刻种植的临床效果。方法23例下颌第一磨牙经微创拔牙后，植入Nobel Replace根形种植体，记录种植体完全就位时的植入扭矩值；以骨替代材料和胶原生物膜完成种植体周围骨缺损的处理，安装宽颈愈合基台，采用开放愈合方式，分别于种植体植入10 d后拆线，第1、3、6个月复诊，6个月后完成上部结构修复，完成修复后随诊3个月。记录受植区软组织情况及愈合基台稳固情况，评价修复后的咀嚼功能。结果23颗种植体植入时平均扭矩值为（38．90±10．97）N· cm；愈合基台周围的牙龈组织在术后1～2 w趋于稳定，术后6个月时愈合基台周围上皮袖口形成，符合软组织生物封闭的要求，修复后正常行使咀嚼功能。结论严格控制适应证，下颌第一磨牙即刻种植可获得良好的初期稳定性及修复效果；下颌第一磨牙区采用宽颈愈合基台开放愈合，可获得良好的软组织封闭和软组织愈合。