口腔疾病防治 ›› 2022, Vol. 30 ›› Issue (7): 483-490.DOI: 10.12016/j.issn.2096-1456.2022.07.004

• 临床研究 • 上一篇    下一篇

上颌美学区唇侧骨板部分缺损行即刻种植和延期种植的前瞻性队列研究

苏镇亚(), 李诗琪, 莫安春()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院种植科,四川 成都(610041)
  • 收稿日期:2021-11-08 修回日期:2022-01-16 出版日期:2022-07-20 发布日期:2022-04-25
  • 通讯作者: 莫安春
  • 作者简介:苏镇亚,主治医师,博士研究生,Email: suzhenya@stu.scu.edu.cn
  • 基金资助:
    国家重点研发项目(2016YFA0201703);四川省卫健委重点项目(19ZD008);四川大学华西口腔医院临床研究项目(LCYJ2020-YF-2)

A prospective cohort study of immediate implantation and delayed implantation for a labial bony dehiscence defect in the maxillary aesthetic area

SU Zhenya(), LI Shiqi, MO Anchun()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Implantation, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2021-11-08 Revised:2022-01-16 Online:2022-07-20 Published:2022-04-25
  • Contact: MO Anchun
  • Supported by:
    National Key Research and Development Program of China(2016YFA0201703);Sichuan Health Research Project(19ZD008);Clinical Research Project of West China Hospital of Stomatology, Sichuan University(LCYJ2020-YF-2)

摘要:

目的 探讨唇侧骨板部分缺损的患者行即刻种植和延期种植对术后软硬组织变化情况及美学效果的影响。方法 将40例唇侧骨板呈有利型裂开式骨缺损,且缺损高度不超过4 mm的上颌单颗前牙患者分为即刻种植组(20例)和延期种植组(20例),两组均在全程导板引导下植入Nobel Active种植体,种植体颈部平台位于唇侧龈缘根方3 ~ 4 mm。植入后两组均行即刻修复,并应用Bio-Oss骨粉及Bio-Gide膜同期行引导骨再生术(guided bone regeneration,GBR)。比较两组种植体成功率、种植体唇侧骨板厚度变化、种植体唇侧轮廓厚度变化以及红色美学评分(pink esthetic score,PES)。结果 两组患者的种植体成功率均为100%,随访期间未发生并发症。两组术后唇侧骨板均在种植体颈部观察到最大的骨吸收量,术后12个月即刻种植组的颈部骨吸收量为(1.29 ± 0.71)mm,延期种植组为(1.43 ± 0.19)mm,但两组间在各测量位点骨吸收量差异均无统计学意义。即刻种植组和延期种植组术后6个月及12个月唇侧龈缘最高点以及近远中牙龈乳头高度的变化量差异均无统计学意义;PES评分在术后12个月分别为(10.95 ± 1.51)分和(11.05 ± 1.23)分。结论 对于唇侧骨板呈有利型裂开式骨缺损,且缺损高度不超过4 mm的上颌单颗前牙,在即刻种植和延期种植后行即刻修复及同期GBR均为可行的治疗方案。

关键词: 即刻种植, 延期种植, 即刻修复, 引导骨再生术, 唇侧骨板缺损, 有利型骨缺损, 裂开式骨缺损, 翻瓣手术, 美学区, 上前牙区

Abstract:

Objective To investigate the effect of immediate and delayed implant placement on dimensional changes in hard and soft tissues as well as esthetic outcomes. Methods A total of 40 maxillary single anterior teeth with a dehiscence defect on the labial bone (≤4 mm) were categorized into two groups according to the timing of implant placement: immediate implant placement (n = 20) or delayed implant placement (n = 20). Guided bone regeneration (GBR) was conducted at the sites using a flap approach, and the implants were given immediate provisionalization. Implant survival rates, dimensional changes in hard and soft tissues during the six- and twelve-month follow-ups, and pink esthetic scores (PESs) were measured. Results The implant survival rates in both groups were 100%, and no complications occurred during the follow-up time. There was no significant difference between the two groups at the measurement sites in the dimensional change of hard and soft tissues during the six- and twelve-month follow-ups. The largest resorption was observed at the implant neck, with a loss of (1.29 ± 0.71) mm in the immediate implant placement group and (1.43 ± 0.19) mm in the delayed implant placement group. The mean PES scores were (10.95 ± 1.51) for the immediate implant placement group and (11.05 ± 1.23) for the delayed implant placement group. Conclusion Immediate implantation or delayed implantation combined with GBR and immediate provisionalization might both be a prospective treatment strategy for a maxillary single anterior tooth with a dehiscence defect on the labial bone.

Key words: immediate implant placement, delayed implant placement, immediate provisionalization, guided bone regeneration, labial bony defect, friendly bone defect, dehiscence defect, flap surgery, esthetics zone, maxillary anterior region

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