同期植骨的即刻与延期种植在上颌中切牙区的骨量对比研究  

A Comparative Study of Alveolar Bone Volume after Immediate and Delayed Implantation with Guide Bone Regeneration in Maxillary Central Incisor Area

作　　者：董事玲 杨光雯 丁梦[1] 李强 董衡[1] 牟永斌[1] DONG Shiling;YANG Guangwen;DING Meng;LI Qiang;DONG Heng;MOU Yongbin(Department of Implantology,Stomatology Hospital,Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China)

机构地区：[1]南京大学医学院附属口腔医院种植科,江苏南京210008

出　　处：《口腔颌面外科杂志》2020年第2期90-95,共6页Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金资助课题(81571800);南京市医学科技发展基金(YKK18124)。

摘　　要：目的:分析比较上颌中切牙即刻种植与延期种植同期唇侧植骨术的疗效。方法:选择2018年度行上颌中切牙区单颗牙种植的患者57例,根据治疗方式分为即刻组(28例)和延期组(29例),2组均同期行唇侧引导骨再生技术(guided bone regeneration,GBR)。所有患者于术前(T0)、术后即刻(T1)、术后6个月(T2)进行锥形束CT(CBCT)检查,并通过影像分析软件测量种植体肩台下2 mm和10 mm处的唇侧水平骨量。结果:在观察期内,2组种植体存留率均为100%。在T1~T2时间段内,即刻组患者2个位点处的唇侧骨板吸收量小于延期组(P<0.05),即刻组2个位点处唇侧剩余骨厚度>2 mm的患者多于延期组,且即刻组获得更好的美学效果与更高的满意度评分。结论:与延期种植相比,即刻种植同期唇侧植骨更有利于减缓牙槽骨吸收,能维持种植体周围软硬组织稳定。Objective:To analyze and compare the clinical effects between immediate and delayed implantation placement with simultaneous bone grafting procedure in the maxillary central incisor area.Methods:57 patients who received dental implantation in the maxillary central incisor area from January to December 2018 were included in this study.The patients were divided into two groups,the immediate group(n=28)and delayed group(n=29),according to the timing of implantation and the simultaneous guided bone regeneration(GBR).All peri-implant bone volumes were evaluated by cone-beam CT(CBCT)before surgery(T0),immediately after operation(T1)and 6 months after surgery(T2).The image analysis software was used to measure the horizontal lingual bone mass at 2 mm and 10 mm sites below the implant shoulder.Results:The success rate of both groups was 100%during observation period.Within the T1~T2 time period,the immediate group showed less bone absorption at the lingual side than the delayed group both at the 2 mm and 10 mm sites below the implant shoulder(P<0.05).Meanwhile,there were more patients in the immediate group revealing thicker lingual bone(>2 mm)at both sites than in the delayed group.Also,the immediate group had better aesthetic effect and higher satisfaction score.Conclusion:Immediate implantation with simultaneous bone grafting procedure showed more reliable clinical effects both in reducing the absorption of alveolar bone at the lingual side and also maintaining the stability of the soft and hard tissues around the implants.

关 键 词：上颌中切牙 即刻种植 延期种植 骨改建 

分 类 号：R782[医药卫生—口腔医学]