数字化引导隧道软组织移植联合临时修复体塑形重建多颗前牙红色美学病例1例

doi:10.12337/zgkqzzxzz.2025.12.003

中国口腔种植学杂志 ›› 2025, Vol. 30 ›› Issue (6): 525-531.DOI: 10.12337/zgkqzzxzz.2025.12.003

• 软组织增量与牙种植专题 • 上一篇下一篇

数字化引导隧道软组织移植联合临时修复体塑形重建多颗前牙红色美学病例1例

罗岚¹, 王君琳², 陈琳², 赖心如², 林洁², 周灵², 赵伟³

¹福建医科大学口腔医学院·附属口腔医院牙周科,福州 350002;
²福建医科大学口腔医学院·附属口腔医院福建省高校口腔医学重点实验室,福州 350002;
³福建医科大学口腔医学院·附属口腔医院种植科,福州 350002

收稿日期:2025-09-11 出版日期:2025-12-30 发布日期:2025-12-23
通讯作者: 赵伟,Email：diovdentist@126.com,电话：0591-83754882
作者简介:罗岚,主治医师,研究方向：口腔牙周病学相关研究.。
赵伟,副主任医师,研究方向：口腔种植学及口腔美学相关研究。
基金资助:
福建省卫生健康中青年骨干人才培养项目（2024GGA074）; 国家级大学生创新训练计划（202410392010）; 福建省自然科学基金项目（2025J01815）

Digitally guided tunnel soft tissue augmentation combined with temporary restoration contouring for pink esthetic reconstruction in multiple anterior teeth: a case report

Luo Lan¹, Wang Junlin², Chen Lin², Lai Xinru², Lin Jie², Zhou Ling², Zhao Wei³

¹Department of Periodontology, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, Fujian, China;
²School and Hospital of Stomatology, Fujian Medical University & Stomatological Key Laboratory of Fujian College and University,Fuzhou 350002, Fujian,China;
³Department of Implantology, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, Fujian, China

Received:2025-09-11 Online:2025-12-30 Published:2025-12-23
Contact: Zhao Wei, Email: diovdentist@126.com, Tel: 0086-591-83754882
Supported by:
Young and Middle-aged Key Talent Training Program of the Fujian Provincial Health Commission (2024GGA074); National Innovation and Entrepreneurship Training Program for College Students (202410392010); Natural Science Foundation of Fujian Province (2025J01815)

摘要/Abstract

摘要： 连续多颗前牙缺失常导致牙槽嵴出现水平及垂直向骨吸收,并伴随软组织塌陷,从而给种植修复带来极大挑战,在前牙美学区实现理想的“红色美学”是临床中的重要难点。本文报告1例针对上颌前牙连续缺失、实施了有序协同的多阶段治疗流程的患者治疗病例：一期手术在数字化手术导板引导下植入种植体,并联合引导骨再生恢复唇侧骨量;二期手术采用隧道技术联合结缔组织移植,以增加软组织厚度并优化软组织结构;后期,应用纳米陶瓷树脂复合材料制作的种植体支持式临时修复体,逐步进行穿龈轮廓调改,塑造协调饱满的种植体周软组织形态。这一多阶段的协调种植治疗最终获得了近似天然牙的自然轮廓与协调自然的颜色外观,实现了最佳的红白美学效果。该综合治疗模式将外科增量与临时修复体引导的种植体周软组织塑形相结合,即隧道技术在改善软组织轮廓及厚度方面体现了微创且精准的优势;纳米陶瓷树脂复合材料则表现出优异的稳定性与可调整性,促进了种植体周软组织结构的逐步成熟。这一临床方案为前牙美学区复杂软组织管理提供了可预测且可靠的治疗策略。

关键词: 前牙美学区, 多阶段治疗流程, 软组织增量, 隧道技术, 穿龈轮廓, 临时修复体塑形, 纳米陶瓷树脂复合材料

Abstract: The loss of multiple consecutive anterior teeth frequently results in horizontal and vertical alveolar ridge resorption accompanied by soft tissue collapse, presenting formidable challenges for implant rehabilitation. Achieving ideal "pink esthetics" in the anterior esthetic zone represents a significant clinical difficulty. This case report describes an orchestrated multistage protocol for managing a patient with multiple missing maxillary anterior teeth. The first-stage surgical procedure employed digitally guided implant placement in conjunction with guided bone regeneration (GBR) to restore labial bone volume. During the second-stage procedure, a tunnel technique combined with connective tissue grafting was implemented to augment soft tissue thickness and optimize tissue architecture. Subsequently, an implant-supported provisional restoration, fabricated from a nanoceramic resin composite material, was utilized for progressive emergence profile conditioning, thereby establishing a harmonious and voluminous peri-implant soft tissue morphology. This multistage coordinated implant treatment ultimately achieved natural contours and harmoniously blended color comparable to those of natural teeth, resulting in optimal pink-and-white esthetic outcomes. This integrated treatment paradigm combines surgical augmentation with provisional restoration-guided gingival contouring: the tunnel technique provides minimally invasive precision in enhancing soft tissue profile and dimensional thickness, while the nanoceramic resin composite demonstrates excellent stability and adjustability characteristics, facilitating gradual gingival architecture maturation. This clinical protocol establishes a predictable and reliable treatment strategy for complex soft tissue management in anterior esthetic zone cases.

Key words: Anterior esthetic zone, Multistage treatment protocol, Soft tissue augmentation, Tunnel technique, Emergence profile, Provisional restoration contouring, Nanoceramic resin composite

罗岚,王君琳,陈琳,等. 数字化引导隧道软组织移植联合临时修复体塑形重建多颗前牙红色美学病例1例[J]. 中国口腔种植学杂志, 2025, 30(6): 525-531. DOI: 10.12337/zgkqzzxzz.2025.12.003

Luo Lan, Wang Junlin, Chen Lin, Lai Xinru, Lin Jie, Zhou Ling, Zhao Wei. Digitally guided tunnel soft tissue augmentation combined with temporary restoration contouring for pink esthetic reconstruction in multiple anterior teeth: a case report[J].Chinese Journal of Oral Implantology, 2025, 30(6): 525-531.DOI: 10.12337/zgkqzzxzz.2025.12.003.

参考文献

[1] Takács A, Hardi E, Cavalcante BGN, et al.Advancing accuracy in guided implant placement: a comprehensive meta-analysis: meta-analysis evaluation of the accuracy of available implant placement methods[J]. J Dent, 2023,139:104748. DOI: 10.1016/j.jdent.2023.104748.
[2] Avila-Ortiz G, Gonzalez-Martin O, Couso-Queiruga E, et al.The peri-implant phenotype[J]. J Periodontol, 2020,91(3):283-288. DOI: 10.1002/JPER.19-0566.
[3] Thoma DS, Gil A, Hämmerle CHF, et al.Management and prevention of soft tissue complications in implant dentistry[J]. Periodontol 2000, 2022,88(1):116-129. DOI: 10.1111/prd.12415.
[4] Jundaeng J, Chamchong R, Nithikathkul C. Dental implant in esthetic zone: a case report[J]. SAGE Open Med Case Rep, 2025,13:2050313X241311702. DOI: 10.1177/2050313X241311702.
[5] Zucchelli G, Tavelli L, McGuire MK, et al. Autogenous soft tissue grafting for periodontal and peri-implant plastic surgical reconstruction[J]. J Periodontol, 2020,91(1):9-16. DOI: 10.1002/JPER.19-0350.
[6] Zucchelli G, Mounssif I, Mazzotti C, et al.Coronally advanced flap with and without connective tissue graft for the treatment of multiple gingival recessions: a comparative short-and long-term controlled randomized clinical trial[J]. J Clin Periodontol, 2014,41(4):396-403. DOI: 10.1111/jcpe.12224.
[7] Chang TH, Alshatti R, Mordini L.Coronally advanced flap versus tunnel on the treatment of gingival recession and peri-implant mucosal defects: a review of current clinical indications[J]. Dent Rev, 2024,4(2):100090. DOI: 10.1016/j.dentre.2024.100090.
[8] Raetzke PB.Covering localized areas of root exposure employing the "envelope" technique[J]. J Periodontol, 1985,56(7):397-402. DOI: 10.1902/jop.1985.56.7.397.
[9] Tavelli L, Barootchi S, Cairo F, et al.The effect of time on root coverage outcomes: a network meta-analysis[J]. J Dent Res, 2019,98(11):1195-1203. DOI: 10.1177/0022034519867071.
[10] Sun TC, Chang T.Soft tissue management around dental implant in esthetic zone-the current concepts and novel techniques[J]. J Dent Sci, 2024,19(3):1348-1358. DOI: 10.1016/j.jds.2024.03.003.
[11] Su H, Gonzalez-Martin O, Weisgold A, et al.Considerations of implant abutment and crown contour: critical contour and subcritical contour[J]. Int J Periodontics Restorative Dent, 2010,30(4):335-343.
[12] Gomez-Meda R, Esquivel J, Blatz MB.The esthetic biological contour concept for implant restoration emergence profile design[J]. J Esthet Restor Dent, 2021,33(1):173-184. DOI: 10.1111/jerd.12714.
[13] Wittneben J, Buser D, Belser UC, et al.Peri-implant soft tissue conditioning with provisional restorations in the esthetic zone: the dynamic compression technique[J]. Int J Periodontics Restorative Dent, 2013,33(4):447-455. DOI: 10.11607/prd.1268.
[14] Engel A, Kranz HT, Schneider M, et al.Biofilm formation on different dental restorative materials in the oral cavity[J]. BMC Oral Health, 2020,20(1):162. DOI: 10.1186/s12903-020-01147-x.
[15] Kozmos M, Virant P, Rojko F, et al.Bacterial adhesion of streptococcus mutans to dental material surfaces[J]. Molecules (Basel, Switzerland), 2021,26(4):1152.DOI: 10.3390/molecules26041152.
[16] Song F, Koo H, Ren D.Effects of material properties on bacterial adhesion and biofilm formation[J]. J Dent Res, 2015,94(8):1027-1034. DOI: 10.1177/0022034515587690.
[17] Teughels W, Van Assche N, Sliepen I, et al.Effect of material characteristics and/or surface topography on biofilm development[J]. Clin Oral Implants Res, 2006,17(Suppl 2):S68-S81. DOI: 10.1111/j.1600-0501.2006.01353.x.
[18] Singh P, Shenoy A, Nallaswamy D, et al.Comparative evaluation of microbial adhesion on provisional crowns fabricated with milled polymethylmethacrylate (PMMA) and conventional acrylic resin: a prospective clinical trial[J]. Cureus, 2024,16(7):e64469. DOI: 10.7759/cureus.64469.
[19] Al-Dwairi ZN, Ebrahim AAAH, Baba NZ.A comparison of the surface and mechanical properties of 3D printable denture-base resin material and conventional polymethylmethacrylate (PMMA)[J]. J Prosthodont, 2023,32(1):40-48. DOI: 10.1111/jopr.13491.
[20] Luchinskaya D, Du R, Owens DM, et al.Various surface treatments to implant provisional restorations and their effect on epithelial cell adhesion: a comparative in vitro study[J]. Implant Dent, 2017,26(1):12-23. DOI: 10.1097/ID.0000000000000538.

数字化引导隧道软组织移植联合临时修复体塑形重建多颗前牙红色美学病例1例

Digitally guided tunnel soft tissue augmentation combined with temporary restoration contouring for pink esthetic reconstruction in multiple anterior teeth: a case report

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