上颌前牙区即刻种植即刻修复与延迟修复牙槽嵴改建的锥形束CT观察  

Cone-beam CT evaluation of alveolar ridge modification subject to immediate implant with immediate loading and delayed loading

作　　者：王莺[1] 林野[1] 陈波[1] 张宇[1] 邸萍[1] 易纯[1] 

机构地区：[1]北京大学口腔医学院·口腔医院种植科口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室,100081

出　　处：《中华口腔医学杂志》2016年第10期600-604,共5页Chinese Journal of Stomatology

基　　金：第五期中央保健科研课题（W2013BJ42）

摘　　要：目的：通过锥形束CT分析比较上颌前牙区即刻种植即刻修复与即刻种植延迟修复后牙槽嵴改建的变化，以期为前牙即刻种植提供临床参考。方法回顾分析2010年8月至2012年12月行上颌切牙即刻种植的患者34例，根据治疗方式进行分组，延迟修复组（18例患者，21枚种植体）即刻种植经常规愈合期后延迟修复，即刻修复组（16例患者，22枚种植体）即刻种植当日即刻修复。种植术后即刻和术后6个月拍摄局部锥形束CT，测量种植体肩台处及其下2、4、6、8 mm处牙槽嵴宽度和牙槽嵴高度，计算术后6个月与术后即刻的差值，计为变化量。两组结果用独立样本t检验进行分析。结果两组患者种植体成功率均为100%。延迟修复组牙槽嵴厚度变化量最大的位置在种植体肩台下6 mm处，即种植体中部，为（-0.75±1.31）mm。两组各测量位点牙槽嵴宽度变化量差异均无统计学意义（P〉0.05）。延迟修复组牙槽嵴高度变化量[（-0.73±1.88）mm]与即刻修复组[（0.39±1.37）mm]差异有统计学意义（P〈0.05）。结论严格把握即刻种植适应证的即刻种植即刻修复，可减少牙槽骨改建。Objective To assess and compare the radiographic outcomes of immediate implant placement with two different loading timing. Methods The involved cases were collected from Department of Implantology, Peking University School and Hospital of Stomatology. Patients recieved immediate implant placement during 2010 Aug to 2012 Dec. The cases admitted delayed restoration program were assigned to Group Ⅰ（18 patients with 21 implants）, the cases admitted immediate restoration program were assigned to Group Ⅱ（16 patients with 22 implants）. Cone-beam CT（CBCT） was taken on the day after surgery and 6 months later. The thickness of the alveolar and the vertical alteration of marginal bone level were measured using the computer software subject to the CBCT. Wound closure was performed by single sutures in Group Ⅰ. Provisional crown was delivered on the same day of implant insertion or the day after for Group Ⅱ. Comparisons between baseline data and data from 6-month follow-up in both groups were conducted using paired t test（α =0.05）. Results The success rates of two groups were both 100% . The thickness got alteration after 6 months. The largest alteration position was at the 6 mm apical to the implant platform in Group Ⅰ, which was （-0.75±1.31） mm. In Group Ⅱ for each platform got similar alterations as -0.3 mm. There was no significant differences. Vertical alteration in two Groups showed significant difference, with （- 0.73 ± 1.88） mm（Group Ⅰ） and （0.39 ± 1.37） mm（Group Ⅱ） respectively. Conclusions Immediate restoration of dental implants which are placed in fresh extraction sockets has more advantages than delayed restoration protocol, for it shortens the course of treatment and preserves the alveolar bone.

关 键 词：锥束计算机体层摄影术 即刻负荷牙种植体 牙槽骨质丢失 

分 类 号：R783.6[医药卫生—口腔医学]