即刻种植和早期种植对前牙美学区种植体周软组织影响的比较研究
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摘要
目的分析与探讨采用即刻种植与早期种植治疗上前牙单牙种植修复患者的临床疗效,并研究其对患者前牙美学区种植体周软组织影响。方法将2014年4月～2016年4月期间经我院诊疗46例上前牙单牙种植修复患者,采用数字表法根据治疗方案不同分成两组,每组23例。对照组给予早期种植治疗,观察组给予即刻种植治疗。观察两组基线期及治疗2年后红色美学指数(PES)、患者满意度以及种植体留存情况。结果观察组基线期边缘龈水平(1.17±0.25)分、近中龈乳头(1.60±0.42)分、远中龈乳头(1.51±0.37)分、软组织外形(0.39±0.01)分、软组织质地及颜色(0.46±0.05)分、牙槽突外形(1.19±0.21)分、美观率(56.52%)均优于对照组边缘龈水平(0.56±0.21)分、近中龈乳头(0.68±0.18)分、远中龈乳头(0.47±0.18)分、软组织外形(0.28±0.04)分、软组织质地及颜色(0.31±0.02)分、牙槽突外形(0.27±0.04)分、美观率(21.74%),差异有统计学意义(P<0.05)。两组治疗2年后PES各项评分、美观率及种植体留存情况比较无差异(P>0.05)。结论即刻种植及早期种植治疗后种植体留存情况及远期美学效果无差异,但即刻种植能够显著改善患者基线期前牙种植体周软组织美学效果,满足患者期望值。
Objective To analyze and discuss the clinical effect of immediate implant and early implant of patients with single tooth. Meanwhile to evaluate the pink esthetic outcome of single dental implants. Methods The total of 46 cases with single tooth implants from April 2014 to April 2016 treated by our hospital were included, They are divided into 23 cases in each group by digital table method: The control group was treated with early implantation, while experimental group was treated with immediate implantation. In experimental group, the implants were placed immediately into fresh extraction and immediate restored with temporary abutments and temporary crowns.The provisional prosthesis were adjusted gradually to guide the peri-implant soft tissue remodeling during healing.The implants were restored with final restorations after 4 months and assessed using pink esthetic scores(PES)and implant survival rate in the two groups at baseline and 2 years after treatment were recorded. Results The gingival margin level scores(1.17 ±0.25), mesial gingival papilla scores(1.60±0.42), distal gingival papilla scores(1.51±0.37), soft tissue scores(0.39±0.01), soft tissue texture and color scores(0.46+0.05), alveolar process scores(1.19±0.21) and aesthetic rate(56.52%) were superior to the control group at baseline. The marginal gingival level scores(0.56±0.21), proximal gingival papilla scores(0.68±0.18), distal gingival papilla scores(0.47±0.18), soft tissue shape scores(0.28±0.04), soft tissue texture and color scores(0.31±0.02), alveolar process scores(0.27±0.04)and aesthetic rate(21.74%)were statistically significant(P<0.05).After two years after the implant surgery, there was no difference in PES scores, aesthetic rate and implant retention in 2 years(P>0.05). Conclusion There is no difference in the retention and long-term aesthetic effect of implants after immediate implantation and early implantation, however, Immediate implantation can significantly improve the aesthetic effect of the soft tissue of the anterior dental implants at baseline period, and at the same time, they can meet the patient's expectations.
Objective To analyze and discuss the clinical effect of immediate implant and early implant of patients with single tooth. Meanwhile to evaluate the pink esthetic outcome of single dental implants. Methods The total of 46 cases with single tooth implants from April 2014 to April 2016 treated by our hospital were included, They are divided into 23 cases in each group by digital table method: The control group was treated with early implantation, while experimental group was treated with immediate implantation. In experimental group, the implants were placed immediately into fresh extraction and immediate restored with temporary abutments and temporary crowns.The provisional prosthesis were adjusted gradually to guide the peri-implant soft tissue remodeling during healing.The implants were restored with final restorations after 4 months and assessed using pink esthetic scores(PES)and implant survival rate in the two groups at baseline and 2 years after treatment were recorded. Results The gingival margin level scores(1.17 ±0.25), mesial gingival papilla scores(1.60±0.42), distal gingival papilla scores(1.51±0.37), soft tissue scores(0.39±0.01), soft tissue texture and color scores(0.46+0.05), alveolar process scores(1.19±0.21) and aesthetic rate(56.52%) were superior to the control group at baseline. The marginal gingival level scores(0.56±0.21), proximal gingival papilla scores(0.68±0.18), distal gingival papilla scores(0.47±0.18), soft tissue shape scores(0.28±0.04), soft tissue texture and color scores(0.31±0.02), alveolar process scores(0.27±0.04)and aesthetic rate(21.74%)were statistically significant(P<0.05).After two years after the implant surgery, there was no difference in PES scores, aesthetic rate and implant retention in 2 years(P>0.05). Conclusion There is no difference in the retention and long-term aesthetic effect of implants after immediate implantation and early implantation, however, Immediate implantation can significantly improve the aesthetic effect of the soft tissue of the anterior dental implants at baseline period, and at the same time, they can meet the patient's expectations.
引文
1张艺平,陈小凡.即刻种植修复前牙缺失的临床效果.中国医药导报,2017,14(12):125-128.
2马全诠,蔡潇潇.美学区即刻种植即刻修复的研究现状.国际口腔医学杂志,2017,44(6):731-736.
3 Gomez-Roman G,Launer S.Peri-implant bone changes in immediate and non-immediate root-analog stepped implantsa matched comparative prospective study up to 10 years.International Journal of Implant Dentistry,2016,2(1):15.
4 Malchiodi L,Balzani L,Cucchi A.Primary and secondary stability of implants in postextraction and healed sites:a randomized controlled clinical trial.Int J Oral Maxillofac Implants,2016,31(6):1435-1443.
5 Belser U,Buser D,Higginbottom F.Consensus statements and recommended clinical procedures regarding esthetics in implant dentistry.Int J Oral Maxillofac Implants,2004,19(Suppl):73-74.
6曹建强,王丽芳,田碧媛,等.上前牙外伤脱落即刻种植美学修复设计的研究.口腔医学,2017,37(6):528-531.
7李涛,吴凯南,李琳,等.改良方法制作过渡义齿在牙种植美学修复软组织成形中的临床应用.口腔颌面外科杂志,2017,27(2):116-120.
8 Milillo L,Fiandaca C,Giannoulis F,et al.Immediate vs non-immediate loading post-extractive implants:a comparative study of implant stability quotient(ISQ).Oral&Implantology,2016,9(3):123-131.
9曾小法,陈宁,尹颖.上颌中切牙微创拔牙即刻种植联合牙龈诱导的美学效果.口腔医学研究,2017,33(12):1323-1327.
10唐丽宇,龚飞飞,庄劭玉,等.即刻修复与延期修复对美学区种植体周围软组织影响比较.安徽医学,2017,38(10):1270,1272.
11黄伟,张志宏,程旭,等.牙龈自我修复后即刻种植后软组织变化的对比研究.临床口腔医学杂志,2017,33(10):609,612.
12 W.G.Van Nimwegen,R.J.Goene,A.C.L.Van Daelen,et al.Immediate implant placement and provisionalisation in the aesthetic zone.J Oral Rehabil,2016,43(10):745-752.
13骆奇峰.上颌前牙单牙即刻种植即刻修复与延期种植修复对患者植体周围软组织和主观满意度的影响.中华全科医学,2017,15(8):1355,1357.
14邹晋阳,谢志刚.软硬组织美学风险及前牙即刻种植中植入深度的研究进展.医学综述,2018,24(5):972-976.
15 DI Girolamo M,Arullani CA,CALCATERRA R,et al.Preservation of extraction socket in immediate implant placement:a clinical study.Oral&Implantology,2016,9(4):222-232.
16祝岩,万澎波,赵伟,等.上颌前牙美学区连续多颗牙缺失即刻种植的临床研究.口腔医学,2016,36(8):700-705.
17蒋澍.前牙即刻种植的修复效果及美学意义.中国美容医学,2018,27(4):76,78.
2马全诠,蔡潇潇.美学区即刻种植即刻修复的研究现状.国际口腔医学杂志,2017,44(6):731-736.
3 Gomez-Roman G,Launer S.Peri-implant bone changes in immediate and non-immediate root-analog stepped implantsa matched comparative prospective study up to 10 years.International Journal of Implant Dentistry,2016,2(1):15.
4 Malchiodi L,Balzani L,Cucchi A.Primary and secondary stability of implants in postextraction and healed sites:a randomized controlled clinical trial.Int J Oral Maxillofac Implants,2016,31(6):1435-1443.
5 Belser U,Buser D,Higginbottom F.Consensus statements and recommended clinical procedures regarding esthetics in implant dentistry.Int J Oral Maxillofac Implants,2004,19(Suppl):73-74.
6曹建强,王丽芳,田碧媛,等.上前牙外伤脱落即刻种植美学修复设计的研究.口腔医学,2017,37(6):528-531.
7李涛,吴凯南,李琳,等.改良方法制作过渡义齿在牙种植美学修复软组织成形中的临床应用.口腔颌面外科杂志,2017,27(2):116-120.
8 Milillo L,Fiandaca C,Giannoulis F,et al.Immediate vs non-immediate loading post-extractive implants:a comparative study of implant stability quotient(ISQ).Oral&Implantology,2016,9(3):123-131.
9曾小法,陈宁,尹颖.上颌中切牙微创拔牙即刻种植联合牙龈诱导的美学效果.口腔医学研究,2017,33(12):1323-1327.
10唐丽宇,龚飞飞,庄劭玉,等.即刻修复与延期修复对美学区种植体周围软组织影响比较.安徽医学,2017,38(10):1270,1272.
11黄伟,张志宏,程旭,等.牙龈自我修复后即刻种植后软组织变化的对比研究.临床口腔医学杂志,2017,33(10):609,612.
12 W.G.Van Nimwegen,R.J.Goene,A.C.L.Van Daelen,et al.Immediate implant placement and provisionalisation in the aesthetic zone.J Oral Rehabil,2016,43(10):745-752.
13骆奇峰.上颌前牙单牙即刻种植即刻修复与延期种植修复对患者植体周围软组织和主观满意度的影响.中华全科医学,2017,15(8):1355,1357.
14邹晋阳,谢志刚.软硬组织美学风险及前牙即刻种植中植入深度的研究进展.医学综述,2018,24(5):972-976.
15 DI Girolamo M,Arullani CA,CALCATERRA R,et al.Preservation of extraction socket in immediate implant placement:a clinical study.Oral&Implantology,2016,9(4):222-232.
16祝岩,万澎波,赵伟,等.上颌前牙美学区连续多颗牙缺失即刻种植的临床研究.口腔医学,2016,36(8):700-705.
17蒋澍.前牙即刻种植的修复效果及美学意义.中国美容医学,2018,27(4):76,78.