牙槽骨位点保存术后即刻种植与延期种植的效果对比
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摘要
目的对比观察使用Bio-Oss骨粉与改良型富血小板纤维蛋白(A-PRF)混合物行下颌后牙牙槽骨位点保存术后,即刻种植与延期种植修复的临床效果。方法选择行下颌后牙种植修复治疗的患者78例78颗牙,随机分为观察组和对照组各39例,在拔牙后均使用Bio-Oss骨粉和A-PRF混合物行牙槽骨位点保存术,观察组与对照组分别在术后即刻或6个月后延期植入种植体,并均在种植体植入后6个月行修复治疗。对比两组在种植修复后3、6、12个月时,种植体边缘骨吸收程度;修复后12个月时种植成功率和患者的主观满意度。结果种植修复3、6个月时,观察组种植体边缘骨吸收程度低于对照组(P <0.05),修复后12个月时两组无显著差异(P> 0.05);修复术后12个月,两组均无种植失败,成功率为100%;修复后12个月,观察组患者主观满意度评分明显高于对照组(P <0.05)。结论使用Bio-Oss骨粉和A-PRF混合物行下颌后牙牙槽骨位点保存术后,即刻种植与延期种植均能获得较高的成功率,但即刻种植能有效减少种植体早期的边缘骨吸收,在种植修复后患者主观满意度更高。
Objective To compare the effects of immediate implantation and delayed implantation after of mandibular posterior alveolar bone site preservation with the mixture of Bio-Oss bone meal and ameliorating platelet rich fibrin(A-PRF). Methods A total of 78 patients(78 teeth) who had received mandibular posterior implantation restoration were selected and randomly divided into an observation group and a control group(n=39, respectively). The mixture of Bio-Oss bone meal and A-PRF was used for alveolar bone site preservation. The implants were implanted immediately or six months after the operation in the observation group and the control group respectively. Prosthodontic treatment was conducted six months after the implantation in both groups. The bone resorption degree at the edge of implant three, six and 12 months after implantation restoration and the implantation success rate and the subjective satisfaction of patients 12 months after the restoration were compared between the two groups. Results Three and six months after the implantation, the bone resorption degree at the edge of implant in the observation group was lower than that in the control group(P < 0.05), but there was no significant difference 12 months after the restoration(P > 0.05); 12 months after the restoration, there was no implantation failure in both groups, and the success rate was 100%; 12 months after the restoration, the subjective satisfaction scores of patients in the observation group were significantly higher than those in the control group(P < 0.05).Conclusion Both immediate implantation and delayed implantation after of alveolar bone site preservation with the mixture of Bio-Oss bone meal and A-PRF can obtain high success rate, but immediate implantation can effectively reduce the early marginal bone resorption of the implants and has higher subjective satisfaction after implantation restoration.
Objective To compare the effects of immediate implantation and delayed implantation after of mandibular posterior alveolar bone site preservation with the mixture of Bio-Oss bone meal and ameliorating platelet rich fibrin(A-PRF). Methods A total of 78 patients(78 teeth) who had received mandibular posterior implantation restoration were selected and randomly divided into an observation group and a control group(n=39, respectively). The mixture of Bio-Oss bone meal and A-PRF was used for alveolar bone site preservation. The implants were implanted immediately or six months after the operation in the observation group and the control group respectively. Prosthodontic treatment was conducted six months after the implantation in both groups. The bone resorption degree at the edge of implant three, six and 12 months after implantation restoration and the implantation success rate and the subjective satisfaction of patients 12 months after the restoration were compared between the two groups. Results Three and six months after the implantation, the bone resorption degree at the edge of implant in the observation group was lower than that in the control group(P < 0.05), but there was no significant difference 12 months after the restoration(P > 0.05); 12 months after the restoration, there was no implantation failure in both groups, and the success rate was 100%; 12 months after the restoration, the subjective satisfaction scores of patients in the observation group were significantly higher than those in the control group(P < 0.05).Conclusion Both immediate implantation and delayed implantation after of alveolar bone site preservation with the mixture of Bio-Oss bone meal and A-PRF can obtain high success rate, but immediate implantation can effectively reduce the early marginal bone resorption of the implants and has higher subjective satisfaction after implantation restoration.
引文
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[5]高也,孙勇,赵峰,等.联合使用A-PRF、iPRF与牛骨替代材料在牙槽位点保存术的CBCT观察[J].西南军医,2018,20(2):166-169.
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[7]张鹏飞,孙福星,范亚伟. PRF复合GBR技术在牙槽嵴位点保存中的应用研究[J].中国口腔种植学杂志, 2017, 22(3):112-117.
[8]杨桦,齐华,尹程程,等.后牙即刻种植与延期种植回顾性临床研究[J].实用口腔医学杂志, 2017(6):766-771.
[9]陈子和,何荣发.即刻种植、延期种植、植骨后延期种植3种方式对骨缺损患者的疗效影响比较[J].中国口腔种植学杂志,2017, 22(1):13-15.
[10]何艳召,丁伯峰,田雪丽.前牙微创拔牙后即刻种植和位点保存常规种植疗效比较[J].医学理论与实践, 2018(6):866-868.
[11]张艳靖,王柏翔,刘小利,等.即刻种植和延期种植对种植体周围软组织影响的对比研究[J].实用口腔医学杂志, 2013, 29(4):500-503.
[2] Engel E, Del VS, Aparicio C, et al. Discerning the role of topography and ion exchange in cell response of bioactive tissue engineering scaffolds[J]. Tissue Engineering Part A, 2008, 14(8):1341.
[3] Shie MY, Ding SJ, Chang HC. The role of silicon in osteoblast-like cell proliferation and apoptosis[J]. Acta Biomaterialia, 2011, 7(6):2604-2614.
[4] Kobayashi E, Flückiger L, Fujioka-Kobayashi M, et al.Comparative release of growth factors from PRP, PRF, and advanced-PRF[J]. Clinical Oral Investigations, 2016, 20(9):2353-2360.
[5]高也,孙勇,赵峰,等.联合使用A-PRF、iPRF与牛骨替代材料在牙槽位点保存术的CBCT观察[J].西南军医,2018,20(2):166-169.
[6]林野.口腔种植学[M].北京:北京大学医学出版社,2014:121-122.
[7]张鹏飞,孙福星,范亚伟. PRF复合GBR技术在牙槽嵴位点保存中的应用研究[J].中国口腔种植学杂志, 2017, 22(3):112-117.
[8]杨桦,齐华,尹程程,等.后牙即刻种植与延期种植回顾性临床研究[J].实用口腔医学杂志, 2017(6):766-771.
[9]陈子和,何荣发.即刻种植、延期种植、植骨后延期种植3种方式对骨缺损患者的疗效影响比较[J].中国口腔种植学杂志,2017, 22(1):13-15.
[10]何艳召,丁伯峰,田雪丽.前牙微创拔牙后即刻种植和位点保存常规种植疗效比较[J].医学理论与实践, 2018(6):866-868.
[11]张艳靖,王柏翔,刘小利,等.即刻种植和延期种植对种植体周围软组织影响的对比研究[J].实用口腔医学杂志, 2013, 29(4):500-503.