即刻种植翻瓣与不翻瓣术临床疗效分析

doi:10.19438/j.cjoms.2020.02.011

摘要/Abstract

摘要： 目的:评估即刻种植中翻瓣或不翻瓣手术唇侧骨板骨吸收量、种植体留存率、软组织得分,为临床选择不同的术式提供参考。方法:选取上颌前牙即刻种植的42例患者作为研究对象,分为翻瓣组（22例、24颗种植体）和不翻瓣组（20例、22颗种植体）。应用Mimics软件,通过拟合,比较患者术后当天和术后6个月局部骨量。采用SPSS 20.0软件包分析种植术后6个月时的骨吸收量平均值和方差,统计种植体留存率。于永久修复后2年,对2组患者的粉色美学指数（pink esthetic score, PES）及牙龈乳头指数（papilla index score, PIS）进行评分。结果:翻瓣组与不翻瓣组种植体平台（种植体颈部平台）、中部（种植体长度1/2）、根尖点（种植体最底端）种植术后6个月的骨吸收量分别为（0.591±0.604）、（1.145±0.923）、（0.951±1.092）mm和（0.384±0.321）、（0.469±0.321）、（0.209±0.288）mm。种植体中部及根尖点骨吸收量具有显著差异,种植体颈部骨吸收量无显著差异。2组种植体在观察期内无一脱落,种植体存留率为100%。翻瓣组（19例）及不翻瓣组（18例）单颗种植冠的PES及PIS得分分别为（7.34±1.132）、（8.04±0.631）和（2.04±0.591）、（2.41±0.254）,差异无统计学意义。结论:即刻种植时翻瓣与不翻瓣相比,种植体边缘骨水平均相对稳定,不翻瓣组骨吸收低于翻瓣组。永久修复后2年,两者的PES、PIS无显著差异。

关键词: 即刻种植, 翻瓣, 不翻瓣, 美学, 上颌前牙

Abstract: PURPOSE： This study evaluated bone absorption, implant retention and soft tissue score of the labial bone plate in immediate dental implantation with or without flaps, and provide some guidance for clinical selection of different surgical methods. METHODS: Forty-two patients with immediate dental implantation of maxillary anterior teeth were selected as the subjects of this study. They were divided into flap group (22 cases) with 24 implants and flapless group (20 cases) with 22 implants. Mimics software was used to fit and compare the local bone mass of the patients on the day of operation and 6 months after operation. SPSS 20.0 software package was used to analyze the mean and variance of bone absorption 6 months after implantation, and the retention rate of implants was calculated. Pink esthetic score (PES) and papilla index score(PIS) of the two groups were compared 2 years after permanent restoration. RESULTS: The bone resorption of implant plateau (implant neck plateau), middle (implant length 1/2) and apical (implant lowest end) 6 months after implantation were (0.591±0.604), (1.145±0.923), (0.951±1.092), (0.384±0.321), (0.469±0.321), (0.209±0.288)mm, respectively. There was no significant difference in bone resorption in the middle part of implant and apical bone, except in the neck of implant. The implants in the flap group and the flapless group did not fall off during the observation period, and the implant retention rate was 100%. The pink aesthetic index and gingival papilla index of single tooth in the flap group (19 cases) and the flapless group (18 cases) were (7.34±1.132), (8.04±0.631); (2.04±0.591), (2.41±0.254),respectively(P>0.05). CONCLUSIONS: Immediate implant with flap or flapless technique had relatively stable marginal bone levels. Bone resorption in flapless group was lower than that in flap group. There was no significant difference in PES, PIS and P values between the two groups 2 years after permanent repair, but long-term observation was still needed.

Key words: Immediate Implant, Flap, Flapless, Aesthetics, Anterior teeth

中图分类号:

R782.1

孙亮, 曲哲. 即刻种植翻瓣与不翻瓣术临床疗效分析[J]. 中国口腔颌面外科杂志, 2020, 18(2): 144-147.

SUN Liang, QU Zhe. Study on clinical effectiveness between flap and flapless immediate implant placement[J]. China J Oral Maxillofac Surg, 2020, 18(2): 144-147.

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