上颌前牙区即刻种植后骨量变化:水平向吸收是否影响骨结合  

Changes of bone mass after immediate implant in maxillary anterior region: whether horizonal resorption affects the osseointegration of implants

作　　者：叶彬[1,2] 林臻彦[2] 谢丽丽[2] 孙蕾[2] 高永波[2] 

机构地区：[1]遵义医学院珠海校区,广东省珠海市519041 [2]深圳市龙岗中心医院口腔科,广东省深圳市518116

出　　处：《中国组织工程研究》2014年第24期3835-3839,共5页Chinese Journal of Tissue Engineering Research

基　　金：广东省自然科学基金资助(S2013010014978)~~

摘　　要：背景:目前大量的动物实验和临床研究已证实即刻种植和延期种植同样可获得成功的骨结合,但即刻种植是否能够减少或预防拔牙窝牙槽嵴的生理性骨吸收一直是学者们争论的焦点。目的:利用锥束CT测量评估上颌前牙区即刻种植的近期骨组织变化。方法:选取上颌前牙无法保留适合采取即刻种植的患者18例18颗患牙。于种植当天、6个月、1年行锥束CT检查,分别测量距离种植体肩台4,6,8 mm处牙槽嵴唇侧骨壁的厚度,以及缺失牙牙槽嵴唇颊侧近、远中骨高度。结果与结论:种植后6个月,牙槽嵴唇颊侧骨板近、远中吸收高度分别为(1.83±0.05)mm和(1.50±0.04)mm,距离种植体肩台4,6,8 mm处牙槽嵴唇侧骨板吸收分别为(1.72±0.30)mm,(1.65±0.26)mm,(1.55±0.25)mm;1年后牙槽嵴唇颊侧骨板近、远中吸收高度分别为(0.85±0.04)mm和(0.78±0.05)mm,距离种植体肩台4,6,8 mm处牙槽嵴唇侧水平吸收(0.52±0.20)mm,(0.45±0.16)mm,(0.32±0.15)mm。结果表明即刻种植后唇侧骨壁会发生水平向吸收,但是不影响种植体的骨结合,1年后骨组织吸收基本稳定。BACKGROUND： Currently a large number of animal experiments and clinical studies have confirmed that, both immediate implants and delayed implants achieve successful osseointegration, but whether immediate implants can reduce or prevent physiological bone resorption of extracted teeth crypt alveolar crest has been the focus of debates among scholars. OBJECTIVE： To evaluate the recent changes of immediate implant bone in anterior maxilla by the use of cone-beam CT. METHODS： Eighteen patients with 18 maxillary anterior teeth that can not be reserved were treated with immediate implantation, and were included in the study. On the surgery day, postoperative 6 months and 1 year, the patients were detected with cone-beam CT. The bone wall thickness at the lingual side of alveolar crest at 4 mm, 6 mm, 8 mm away from the implant shoulder was measured. The bone height at the lingual-buccal side of missing teeth alveolar crest was also recorded. RESULTS AND CONCLUSION： At 6 months after surgery, the bone height at the lingual-buccal side of missing teeth alveolar crest was （1.83±0.05） mm and （1.50±0.04） mm, the bone resorption at the lingual side of alveolar crest at 4 mm, 6 mm, 8 mm away from the implant shoulder was （1.72±0.30） mm, （1.65±0.26） mm, （1.55±0.25） mm, respectively. At 1 year, the bone height at the lingual-buccal side of missing teeth alveolar crest was （0.85± 0.04） mm and （0.78±0.05） mm, the bone resorption at the lingual side of alveolar crest at 4 mm, 6mm, 8 mm away fromthe implant shoulder was （0.52＋0.20） mm, （0.45＋0.16） mm, （0.32＋0.15） mm, respectively. Immediate implant may induce horizontal resorption at the lingual side bone wall, but has no impact on the osseointegration of the implant, and the bone resorption is stable 1 year later.

关 键 词：组织构建 骨组织工程 上颌前牙 即刻种植 骨结合 骨吸收 广东省自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]