Chinese Journal of Practical Stomatology ›› 2024, Vol. 17 ›› Issue (1): 15-25.DOI: 10.19538/j.kq.2024.01.003

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  • Online:2024-01-30 Published:2024-02-20

前牙区软硬组织增量相关并发症及临床处理策略

贺培欣,杜博文,陈锐,王爽,段思意,汤雨龙   

  1. 中国人民解放军北部战区总医院口腔科,辽宁  沈阳  110016
  • 作者简介:汤雨龙,医学博士,副主任医师,硕士研究生导师。现任中国人民解放军北部战区总医院口腔科副主任。兼任中华口腔医学会口腔种植专业委员会委员、全科口腔医学专业委员会委员,辽宁省口腔医学会口腔种植专业委员会副主任委员、全科口腔医学专业委员会副主任委员,BioMed Research International和《临床军医杂志》编委。主持和参与国家、省级及全军基金课题12项。发表SCI收录论文7篇。主编专著7部。获国际发明专利1项,获国家发明及实用新型专利6项。
  • 基金资助:
    辽宁省自然科学基金医工交叉联合基金(2022-YGJC-08)

Abstract: Implant restoration in the maxillary anterior region is a challenging task as it is the most critical area for aesthetics in the mouth. However,tooth extraction due to various periodontal and apical problems often leads to insufficient horizontal and vertical bone masses in the alveolar cleft during implant restoration. The surgical procedures for bone augmentation in the anterior alveolar crest region include guided bone tissue regeneration,block bone transfer,and bone splitting and condensing. However,soft tissue collapse can still occur even after bone augmentation surgery. To restore the soft tissue contours of the esthetic zone,free connective tissue transfer is often used clinically. These complex soft and hard tissue surgeries can cause complications such as wound dehiscence,infection,bleeding and hematoma,nerve injuries,implant exposure,necrosis and absorption,soft tissue cracking,and insufficient width or thickness of keratinized gingiva. This study introduces the risk factors and clinical management strategies of complications related to bone augmentation and soft tissue augmentation in the maxillary anterior zone,and presents some risk prevention and control suggestions in order to reduce the incidence of complications.

Key words: dental implantation, esthetic zone, complication, bone augmentation, soft tissue augmentation

摘要: 上前牙区为美学关键区,历来都是种植修复的难点和热点,但因各种牙周和根尖周问题导致的拔牙,常使种植修复面临牙槽嵴水平向及垂直向骨量不足的困境。前牙区牙槽嵴骨增量的手术方法包括引导骨组织再生术、块骨移植术、骨劈开骨挤压术等,而即使采取骨增量手术后仍存在一定数量的病例出现软组织塌陷,为此临床上常采用游离结缔组织移植的方法来恢复美学区的软组织轮廓。由此而来,伴随各种复杂的软硬组织手术,不可避免地会出现一系列并发症,包括创口裂开、感染、出血、血肿,神经损伤,移植物暴露、坏死、吸收,软组织开裂,角化龈宽度、厚度不足等。文章针对上颌前牙区骨增量和软组织增量相关并发症及临床处理策略逐一介绍,并提出风险防控建议,以期降低相关术式并发症的发生率。

关键词: 牙种植, 美学区, 并发症, 骨增量, 软组织增量