骨劈开技术在前牙美学修复中的临床体会

目的：采用骨劈开技术进行前牙美学区种植修复，观察临床效果。方法：选取21例上前牙种植患者，牙槽嵴宽度均在3～4 mm，共27个种植牙位，采用骨劈开手术联合引导骨组织再生术（GBR）种植修复，术后随访一年，比较治疗完成时和一年后复诊时的红色美学指数（PES）。通过临床及X线检查，观察种植体周围组织健康状况和修复体的稳定性，分析和评价骨劈开技术对前牙美学区种植修复的临床效果。结果：种植体一年后成功率92.6%，红色美学指数从（9.60±0.74）变为（10.20±0.85）。结论：在选择合适病例的情况下，骨劈开技术能够使牙槽嵴宽度不足的美学区种植修复患者取得较好的临床效果。

[Abstract] Objective：To evaluate the clinical effect of the implant by bone splitting technique in anterior edentulous zone.Method：21 patients with 27 Ankylos implants were included in this study.The labial-lingual thickness of alveolar was from 3 to 4 mm for everybody，the operation was placed after splitting the bone immediately and constructed with the guided bone regeneration，patients were followed up 1 year after restorations and the PES value after restorations and 1 year later were measure for comparison.X-ray and clinical examination were taken to observe the gingival tissue health and stability of the implant.The clinical effect of the implant by bone splitting technique in anterior edentulous zone were analyzed and evaluated.Result：The success rate of implant was 92.6%.The PES was changed form （9.60±0.74）to （10.20±0.85）one year later.Conclusion：The techniques of bone splitting is a effective method for alveolar bone augmentation and could obtion satisfactory clinical effects of implant in the asthetic zone for right cases.

[Key words] Bone splitting technique；Anterior edentulous zone；Pink esthetic score；Implant

前牙美学区是微笑时暴露的牙及其周围组织结构的区域，此区域牙齿缺失十分常见，不仅影响患者的咀嚼功能和美观，长时间不进行修复治疗甚至会对患者的正常心理健康造成影响。传统的活动或者固定修复技术都有明显的缺点，近年来，种植修复技术的不断成熟完善，已经被认为是牙齿缺失的首选修复方法，被誉为人类的第三副牙齿。前牙美学区进行种植修复时，缺牙区部位牙槽嵴经常呈刃状，基骨骨量不足，而植入种植体需要唇舌向有足够的骨量，才能保证种植修复的功能和美学效果，所以牙槽嵴萎缩区域的种植，经常采用骨劈开技术，联合引导骨组织再生术（GBR）使牙槽嵴骨增量[1]。该技术扩大了前牙种植修复的适应证，也克服了Ⅰ期植骨Ⅱ期种植的缺点，并可得到较好的种植效果[2]。本研究采用Ankylos种植体系统行骨劈开术进行前牙美学区种植修复，并进一步分析讨论骨劈开术在前牙区进行种植修复的红色美学效果影响及该技术在临床种植手术中的操作特点，现报道如下。

1 资料与方法