Ⅳ期B/C级牙周炎患者全牙弓即刻种植修复骨吸收的长期观察  

Full-Arch immediate implantation and restoration in patients with Stage Ⅳ Grade B/C periodontitis

作　　者：李莎 林野[1] 邸萍[1] 张宇[1] 蒋析[1] 邵勇 LI Sha;LIN Ye;DI Ping;ZHANG Yu;JIANG Xi;SHAO Yong(Department of Oral Implantology,Peking University School and Hospital of Stomatology,China,100081;Beijing Elite Dental Clinic)

机构地区：[1]北京大学口腔医院种植科,100081 [2]北京精致望京口腔门诊部

出　　处：《实用口腔医学杂志》2021年第4期492-496,共5页Journal of Practical Stomatology

基　　金：国家重点研发计划(编号:2016YFC1102705);首都卫生发展科研专项(编号:首发2018-2-4102)。

摘　　要：目的:探讨全牙弓种植即刻修复技术在具有高感染和持续性骨吸收风险的IV期B/C级牙周炎患者中应用的可行性与长期边缘骨吸收情况。方法:纳入109例IV期B/C级牙周炎患者,完成基于All-on-4理念的全牙弓拔牙后即刻种植即刻修复治疗,进行1~10年的随访。术后即刻及随后每年拍摄曲面体层片,测量边缘骨吸收值并进行数据分析。结果:109例患者中,共103例患者完成定期随访,其中78例IV期B级牙周炎患者,25例IV期C级。共496枚种植体植入124个颌骨。种植体1、5、10年累积存留率为98.6%,97.5%,97.0%。平均种植体边缘骨吸收在1、5、10年后为(0.8±0.3)、(1.1±0.4)、(1.3±0.4)mm。B级牙周炎组和C级牙周炎组种植体的边缘骨吸收无显著性差异(P>0.05)。直立种植体与倾斜种植体的边缘骨吸收无显著性差异(P>0.05)。结论:全牙弓即刻种植修复技术治疗IV期广泛型B/C级牙周炎患者1~10年的随访中,未观察到炎症易感倾向和边缘骨持续性吸收倾向。Objective:To evaluate the feasibility and long-term marginal bone loss(MBL)outcomes of full arch immediate implantation and restoration in patients with Stage IV Grade B/C periodontitis with high risks of infection and ongoing MBL.Methods:109 patients with Stage IV Grade B/C periodontitis received immediate post-extraction implantation and restoration based on the All-on-4 concept.MBL was measured based on the panoramic radiographs taken immediately after surgery and annually thereafter,data were analyzed.Results:Among the 109 patients,103(78 with Stage IV Grade B and 25 with Stage IV Grade C periodontitis)completed regular follow-up.A total of 496 implants were inserted into 124 arches.The 1.5 and 10-year cumulative survival rate of the implants was 98.6%,97.5%and 97.0%respectively.The average peri-implant MBL was(0.8±0.3)mm,(1.1±0.4)mm and(1.3±0.4)mm at 1,5 and 10-year follow-up,respectively.There was no statistical difference of MBL(P>0.05)between the upright implants and tilted implants,or between Stage B and Stage C periodontitis.Conclusion:The full-arch immediate implant placement and immediate restoration may provide predictable outcomes in patients with Stage IV Grade B/C periodontitis in 1-10-year follow-up.No tendency of infection and ongoing MBL is suggested.

关 键 词：即刻种植 即刻修复 全牙弓种植修复 All-on-4 IV期B/C级牙周炎 边缘骨吸收 

分 类 号：R783.6[医药卫生—口腔医学]