保存不可能な歯を牽引してインプラント埋入部の組織増大を図りインプラント補綴治療を行った上顎前歯部の3症例

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Hopeless teeth can be extruded orthodontically before implant placement, and this technique is effective for implant site development. In single tooth replacement, this technique can provide predictable esthetic outcomes. However, in cases with multiple tooth replacements in esthetic areas, it is relatively difficult to achieve desired esthetic results by this technique. Here, we demonstrate three cases which had one to four hopeless teeth treated with forced eruption before implant placement. In case 1, an upper central incisor was compromised by severe periodontal disease. Single tooth replacement was performed using orthodontic extrusion before tooth extraction and implant placement. An excellent esthetic outcome was achieved. In case 2, the left maxillary lateral and central incisors were not preserved because of vertical root fractures. The lateral incisor was extracted and immediate implant placement with GBR was performed. The left central incisor was extracted after its orthodontic extrusion was achieved to a desired level. Three months later, an implant was placed into the central incisor site. Final prostheses were completed 6 months later. The peri-implant soft and hard tissues were manipulated and maintained in a stable state. In case 3, four maxillary front teeth were compromised by subgingival root caries. These teeth were extruded before tooth extraction. This procedure involved extrusion of both central incisors and subsequent extrusion of right and left lateral incisors after completion of central incision extrusion. Four implants were placed immediately after tooth extraction. Final prostheses were delivered 6 months after implantation. Since the alveolar height of the anterior alveolus was insufficient, artificial gingiva was added to the superstructure. We successfully reconstructed the interdental papillae of superstructures in cases 1 and 2. In case 3 with four missing front teeth, an excellent esthetic outcome was not achieved.
2012-08-31

保存不可能な歯を牽引してインプラント埋入部の組織増大を図りインプラント補綴治療を行った上顎前歯部の3症例

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