摘要
Abstract
Immediate implant placement in the aesthetic zone has become increasingly widespread and has gradu-ally evolved into a conventional techniques for implant procedures in the aesthetic region.To achieve favorable aes-thetic and long-term outcomes,clinicians must possess extensive clinical experience as well as proficient surgical and restorative skills.This study summarizes the key factors influencing the long-term success of immediate implants in the aesthetic zone:strict adherence to the indications for immediate implant placement;thorough preoperative assessment of the patient's systemic and local conditions,along with comprehensive evaluation of aesthetic risks;minimally invasive tooth extraction while preserving the integrity of the labial bone plate;selection of appropriately designed implants and their placement in an ideal three-dimensional position based on the implant's characteristics;utilization of suitable bone and soft tissue augmentation techniques according to the patient's specific hard and soft tissue anatomy,extent of bone defects,and periodontal phenotype;dynamic shaping of soft tissues through continuous adjustments in the emer-gence profile of provisional restorations;design of definitive restorations from the perspectives of health,function,and aesthetics;and implementation of regular follow-up and maintenance protocols after implant treatment,with increased emphasis on peri-implant care for patients who smoke,have diabetes,or undergo anti-osteoporosis therapy.This study proposes a decision-making framework to achieve long-term stable clinical outcomes with immediate implants in the aesthetic zone,providing a reference for clinicians in their clinical decision-making and treatment planning:① for pa-tients assessed as low aesthetic risk(e.g.,thick gingival biotype,absence of hard and soft tissue defects,intact labial bone plate with thickness>1 mm,no acute infection),immediate implant placement after minimally invasive extraction is recommended,with the implant positioned in an ideal three-dimensional location,along with bone grafting in the gap between the implant and the labial bone plate and consideration of connective tissue grafting when required;② for pa-tients assessed as moderate aesthetic risk(e.g.,thin gingival biotype,absence of soft tissue defects,intact labial bone plate but with thickness<1 mm or mild to moderate bone defects involving less than 50%height loss,chronic infection present),immediate implant placement with optimal three-dimensional positioning is feasible,accompanied by bone grafting in the implant-labial bone gap or external bone grafting on the labial aspect,with simultaneous or staged con-nective tissue grafting,or alternatively,use of the socket shield technique for immediate implant placement;③ for pa-tients assessed as high aesthetic risk(e.g.,thin gingival biotype,presence of soft tissue defects,vertical bone deficiency,severe labial bone loss involving>50%height loss,acute infection present),ridge preservation followed by delayed im-plant placement is advised.By adhering to these treatment principles,immediate implant placement in the aesthetic zone can achieve reliable success rates and excellent aesthetic outcomes.关键词
口腔种植/美学区/即刻种植/即刻修复/微创治疗/牙周表型/骨增量/数字化技术/长期效果Key words
dental implants/esthetic zone/immediate implant/immediate loading/minimal invasive therapy/periodontal phenotype/bone augmentation/digital-aided technique/long-term effects分类
医药卫生
