Ten Case Reports Of Implant Restoration In Anterior Aesthetic Zone

Objective:Dentition defect is a common and frequently-occurring disease in prosthodontics,especially when it comes to the aesthetic area of anterior teeth.We should not only restore the integrity of the patient’s dentition,but more importantly,satisfy the patient’s aesthetic wishes as much as possible.Through the collection of cases,this article is mainly to study implants combined with bone augmentation to repair the dentition defect in the aesthetic area of anterior teeth,make up for the lack of lip fullness after missing anterior teeth,combine with relevant literature,sum up experience,give full play to the unique advantages of implant and bone augmentation in the aesthetic area of anterior teeth,and hope to provide some reference for future clinical operation.Methods: A total of 10 patients with anterior dentition defect requiring implant repair were selected from August 2017 to January 2021 in the Affiliated Stomatological Hospital of Dalian Medical University.Before operation,we comprehensively evaluated the health status,routinely detected blood pressure,blood glucose,blood routine and other indicators,carefully inquired whether there were systemic diseases unsuitable for implant,and strictly grasped the indications of implant.The second is the internal examination of the oral cavity.We should have a comprehensive evaluation of the tooth tissue,periodontal condition,and repair space.As aesthetics is involved,we should pay special attention to the position of the patient’s smile line and the biological type of the gingival.At the same time,we should use the aesthetic risk assessment form to evaluate the patients,assist the imaging examination,make a detailed preoperative design for the patients,and explain the treatment plan,scheme,risk,cost and so on.Informed consent was signed by the patient.We made study models and took preoperative photos for archiving.Implant surgery should be performed at a selected time,and appropriate bone augmentation surgery should be performed according to the specific conditions during the operation,such as guided bone regeneration,ridge splitting technique,onlay bone grafting,and then inserted implant.After the operation,we made temporary prosthesis to guide the formation of soft tissue,and selected the appropriate time for permanent repair after good healing.Postoperatively,patients were informed of matters needing attention,and oral hygiene education was emphasized.The patients were followed up for 1-12 months,At the same time,we used Pink Aesthetic Score(PES)to evaluate the aesthetic effect of soft tissue around implants,and White Aesthetic Score(WES)to evaluate the aesthetic effect of prosthesis.The patients’ subjective satisfaction was assessed by using the Visual Analogue Scale(VAS),and thus the effect of the evaluated comprehensively.Thus,we finally comprehensively evaluated the clinical restoration effect and the maintenance status of oral hygiene.Results:Among the 10 cases,there were 4 case with high aesthetic risk,5 cases with moderate aesthetic risk and 1 cases with low aesthetic risk.10 patients were followed up for 1 to 12 months after permanent repair.Through clinical examination,imaging examination and patient complaints,we found that the hard and soft tissues healed well and the implant was stable without shedding.The patients were able to function normally and were satisfied with the fullness of the lip.6 cases after permanent implant restoration,the average score of PES was 8.33,WES was 8.16 and PIS was2.67.The VAS score of 10 patients ranged from 85 to 100,with an average of 90.The peri-implant periodontal condition of 10 patients was well maintained,and the patients were satisfied with the aesthetic restoration effect of "pink and white",however,its long-term effect and long-term stability still need further follow-up evaluation.Conclusion:After 1-12 months of follow-up observation after the final restoration of the case in this paper,the patient’s implant osseointegration is good,and the patient’s labial fullness recovers better,which can meet the patient’s aesthetic requirements.In the restoration of dentition defect in the aesthetic zone of the anterior teeth.Compared with conventional restoration design,such as removable and porcelain all-porcelain crown bridge,implant restoration can reflect its unique advantages.In addition to not destroying the adjacent healthy tooth tissue,it is more obvious that it can maintain or restore the original fullness of the patient’s lip through simultaneous bone grafting,to avoid or reduce alveolar bone absorption after tooth loss.It has more competitive advantage in the area of high aesthetic risk of anterior.For the implant and restoration in the aesthetic area of anterior teeth,every step of the clinical operation is particularly important,of course,it also needs the full cooperation of the surgeon and the patient,which is still worth our further study and learning.