即刻种植术后牙槽突骨板改建及美学效果评价  

Evaluation of alveolar ridge reconstruction and esthetic result following immediate implant

作　　者：王莺[1] 林野[1] 陈波[1] 张宇[1] 邸萍[1] 

机构地区：[1]北京大学口腔医学院.口腔医院种植科,北京100081

出　　处：《北京大学学报（医学版）》2016年第1期121-125,共5页Journal of Peking University:Health Sciences

基　　金：第五期中央保健科研课题(W2013BJ42)资助~~

摘　　要：目的：通过锥形束CT观察测量上颌切牙即刻种植的手术当日与术后6个月牙槽嵴骨板水平向和垂直向的变化量,为前牙即刻种植治疗设计提供临床参考。方法：选取2010年8月至2011年11月于北京大学口腔医院种植科行上颌切牙即刻种植患者20例（其中男性7例,女性13例）,平均年龄（28.41±10.22）岁（20~40岁）,共即刻植入23颗种植体于上前牙新鲜拔牙窝内,不进行即刻修复。术后即刻及术后6个月拍摄锥形束CT,分别测量种植体肩台下0、2、4、6、8 mm处[分别设为测量点1（measuring point 1,MP1）、MP2、MP3、MP4、MP5]牙槽嵴宽度变化及牙槽间隔中心点垂直向高度的变化。术前及永久修复后1年,通过临床检查对牙间乳头高度和唇侧丰满度进行评分。使用SPSS 20.0进行相关统计学分析。结果：所有种植体在永久修复后追踪两年,存留率100%。所有患牙位术后各个位点牙槽嵴水平向宽度均发生了一定程度的吸收改建,在种植体肩台下0、2、4、6 mm等处4个位点术前与术后比较差异均有统计学意义。各位点牙槽嵴水平向宽度分别为：MP1术前为（7.68±0.70）mm,术后为（7.00±0.76）mm;MP2术前为（7.81±0.87）mm,术后为（7.30±0.96）mm;MP3术前为（8.12±1.14）mm,术后为（7.62±1.20）mm;MP4术前为（8.48±1.57）mm,术后为（7.73±1.35）mm,P值分别为0.004,0.034,0.018,和0.016,均〈0.05,术后与术前值相减为牙槽嵴宽度减少量,变化程度较大的测量点为M1和M4,分别为（-0.89±2.06）mm和（-0.74±1.28）mm。牙槽间隔垂直向吸收量在不同系统结果不同：Ankylos系统为（-0.42±1.24）mm,Repalce系统为（-0.91±1.96）mm,经过配对t检验,差异无统计学意义。种植术前唇侧丰满度指数（labial convexity score,LCS）为3的有18个牙位,LCS为4的有2个;永久修复后1年LCS为2的有14个,LCS为3的有5个。术前牙间乳头指数（papilla index score,PSI）为2的有5个牙位,PSI为3的�Objective： To evaluate the bone alteration subject to remodeling and analyze the esthetic result following immediate implant placement of incisors. Methods： In this study, 20 patients （13 women, 7 men） were involved, who needed implants for incisors of maxilla. The patients received 23 im- mediate implants totally. On the day of surgery and 6 months after the implants were placed, Cone beam CT （CBCT） was taken. The thickness of the alveolar ridge and the vertical change of marginal bone levels onthe mesial and distal aspects of theimplants were measured using the computer software （ Planme- caRomexis Viewer 3.6.0. R）. The evaluation of esthetic result by labial convexity score （LCS） and pa- pilla index score （PIS） were analyzed pre-operation and one year after the final crown was delivered. The statistics with paired-t test for the measurement data and Willcoxon test for rating data were done by SPSS 20.0. Results ： The survival rate in the two-year follow-up was 100%. The measuring point 1 （ MP1 ） , MP2, MP3 and MP4 （0, 2, 4, 6 mm apical to the implant platform, respectively） got significant altera- tions after 6 months of the follow-up. These differences were statistically significant （ P 〈 0. 05 ）. The major alteration happened at MP1 and MP4, which got （ - 0. 89 ＋ 2.06） mm and （ - 0. 75 ±1.28 ） mmreduction of the alveolar, respectively. The marginal alveolar ridge resorption was （ - 0.42 ± 1.24） mm and（ -0.91 ± 1.96） mm for Ankylos System and Replace System, respectively, and the difference was not statistical significant . The esthetic results were quite acceptable. Before treatment, 18 incisors rated 3 for LCS,and 2 incisors rated 4 for LCS;after final restoration, only 5 incisors rated 3 for LCS, and 14 incisors rated 2 for LCS. Before treatment, 15 incisors rated 3 for PIS; after final restoration, 13 incisors rated 3 for PIS. There was no statistically significant difference for the PIS pre-operation and 1 year after final restoration, while th

关 键 词：牙种植 美学 牙科 牙槽突 锥束计算机体层摄影术 

分 类 号：R783.4[医药卫生—口腔医学]