近日，蒔美執行長江政倫醫師受全球知名植體品牌士卓曼（Straumann）邀請，前往台灣總部進行臨床植牙專題授課。課程中，他結合多年臨床經驗，分享數位導板與動態導航在植牙治療中的應用策略，並從實際案例出發，解析當代植牙治療在規劃與執行上的思維轉變。
此次研習的核心主題，聚焦於近年臨床討論愈來愈頻繁的一個關鍵問題：植牙的長期穩定性。課程中也進一步探討，如何透過數位化工具與系統化的治療規劃，讓醫師在治療初期所做的每一項決策，都能為植牙多年後的健康與穩定奠定基礎。
Recently, Dr. Cheng-Lun Chiang, CEO of Smile Dental Group, was invited by the globally recognized implant brand Straumann to deliver a clinical lecture at its Taiwan headquarters. Drawing on years of clinical experience, he shared insights into the application of digital surgical guides and dynamic navigation in implant dentistry, illustrating how these technologies are reshaping treatment planning and surgical execution through real clinical cases.
The lecture focused on a topic receiving increasing attention in modern implant dentistry: long-term stability. It explored how digital tools and systematic treatment planning allow clinicians to make decisions early in the treatment process that can influence the long-term health and stability of an implant for many years to come.
植牙真正的挑戰，是在十年之後
The Real Challenge of Implant Dentistry Appears Ten Years Later
江政倫醫師指出，植牙技術發展至今已逾數十年。隨著手術成功率逐年提升，臨床醫師所關注的焦點，也逐漸出現轉變。
過去，常將「植體是否脫落」視為判斷植牙成功與否的唯一指標。然而近年多項歐美長期追蹤研究發現，植體脫落並不是植牙失敗最常見的原因。真正左右植牙長期結果的，往往是植體周圍軟組織隨時間產生的變化。
當牙齦組織逐漸改變時，可能出現牙齦退縮、黑三角，或清潔不易等問題。這些看似細微的變化，往往會在植牙使用多年後逐漸浮現，並進一步影響植牙的穩定性與整體美觀。
因此，在當代植牙治療的思維中，醫師關注的已不僅是手術當下是否順利完成，更重要的是在植體植入時，是否將軟組織條件一併納入整體規劃，並在手術中精準落實設計，讓植牙在十年之後，依然能維持穩定而自然的狀態。
Dr. Chiang noted that implant dentistry has evolved over several decades. As surgical success rates have steadily improved, the focus of clinicians has gradually shifted as well.
In the past, implant success was often judged simply by whether the implant remained in place. However, long-term studies from Europe and the United States have shown that implant loss is not the most common reason for failure. Instead, long-term outcomes are often influenced by changes in the surrounding soft tissue over time.
As the gum tissue gradually changes, issues such as gingival recession, black triangles, or difficulties in maintaining oral hygiene may arise. These subtle changes often become visible years after treatment and can affect both the stability and aesthetics of the implant restoration.
For this reason, modern implant dentistry increasingly focuses not only on whether the surgery is successful today, but on whether the restoration can remain stable and natural ten years later.
精準植體定位，成為長期穩定的核心條件
Precise Implant Positioning as the Foundation of Long-Term Stability
江醫師補充，若植體在手術當下的位置不夠理想，未來在清潔與維護上便可能增加難度，時間一久，也容易對周圍軟組織的健康造成影響。
因此，本次研習課程的重要核心之一，便是探討如何透過數位化工具提升植體定位的精準度。
透過 CBCT 三維影像分析骨骼結構，再結合口腔掃描掌握牙齒與牙齦形態，醫師得以在手術前完成完整的治療規劃。藉由「反向設計」的思維，先確立未來假牙的形態、咬合關係與清潔路徑，再回推植體放置的理想位置，最後搭配數位導板或動態導航系統，使植體能依照既定規劃精準放置。
當植體位置更加精準，未來在清潔與維護上也會相對容易，周圍軟組織更有機會維持長期的穩定與健康。
Against this clinical backdrop, implant positioning has become a critical factor influencing long-term outcomes. Dr. Chiang explained that when an implant is not ideally positioned during surgery, it can create challenges in oral hygiene and long-term maintenance, potentially affecting the health of the surrounding soft tissue over time.
One of the central themes of the lecture, therefore, was how digital technologies can enhance the precision of implant positioning.
Through CBCT imaging to analyze bone structure, combined with intraoral scanning to capture the morphology of teeth and gingiva, clinicians can complete comprehensive treatment planning before surgery. Using a prosthetically driven approach, the final restoration—its shape, occlusion, and hygiene pathway—is first determined. The ideal implant position is then planned accordingly, and surgical tools such as digital guides or dynamic navigation systems help translate that plan accurately during surgery.
When implant placement is precise, long-term hygiene and maintenance become easier, increasing the likelihood of maintaining healthy peri-implant soft tissue over time.
從反向設計到精準執行：數位導板與動態導航的臨床角色
江政倫醫師也強調，植牙治療的思維正在逐漸轉變。
在過去的治療模式中，醫師往往是先將植體植入骨頭，再思考後續假牙與牙齦該如何配合；但在現代數位植牙的概念中，則是先設計未來的假牙形態與牙齦線條，再回推出植體最理想的位置。
藉由「反向設計」方式，醫師可以在手術前就完整掌握最終的結構邏輯，使植體的位置更符合長期使用的需求，也能降低未來清潔與維護上的困難。
而要將這些事前規劃精準落實於臨床手術之中，數位導板與動態導航系統便扮演了關鍵角色。透過這些數位輔助工具，醫師得以在手術過程中依循原先的規劃精準定位，使植體放置的位置更貼近設計目標。
這樣的治療思維，也逐漸成為數位植牙時代的重要臨床方向。
Dr. Chiang also emphasized that the philosophy of implant treatment is gradually evolving.
Traditionally, clinicians would place the implant first and then determine how the final prosthesis and surrounding tissue should adapt. In modern digital implant dentistry, however, the process often begins with designing the final restoration and gingival contour, and then working backward to determine the optimal implant position.
This prosthetically driven approach allows clinicians to fully understand the final structural logic before surgery. As a result, the implant position can better support long-term function and hygiene, while reducing future maintenance challenges. Surgical guides and dynamic navigation systems then help translate the digital plan accurately into the surgical procedure.
This approach is increasingly becoming a key direction in contemporary digital implant dentistry.
放眼10年後的穩定 才是植牙真正的價值
The True Value of Implant Treatment Lies in Stability Years Later
課程接近尾聲時，江政倫醫師再次回到整場分享最核心的觀點。
在他看來，植牙治療真正的價值，不只在於手術當下是否順利完成，更重要的是十年、甚至二十年之後，是否仍能維持自然且穩定的成果。
他認為，從治療思維的建立、手術規劃與設計，到術後照護與長期維護，每一個環節都與植牙的長期穩定息息相關。
未來也期待透過持續的專業交流與臨床經驗分享，為台灣牙醫植牙醫療品質的提升，持續注入向前發展的力量。
Toward the end of the lecture, Dr. Chiang returned to the central idea of his presentation.
In his view, the true value of implant treatment lies not simply in a successful procedure today, but in whether the restoration can remain stable, functional, and natural ten—or even twenty—years later.
From treatment philosophy and surgical planning to postoperative care and long-term maintenance, every step of the process plays a role in determining the long-term stability of implant therapy.
Through continued professional exchange and the sharing of clinical experience, he hopes to contribute to the ongoing advancement of implant dentistry and the overall quality of dental care in Taiwan.
