种植体周围不同黏膜厚度对种植体边缘骨吸收的影响  

Effects of mucosal thickness around implants on marginal bone resorption

作　　者：张侃 裘实 祁燕芳 Zhang Kan;Qiu Shi;Qi Yanfang(Implant Center,Shaoxing Stomatological Hospital,Shaoxing 312000,Zhejiang Province,China;Department of Oral and Maxillofacial Surgery,Shaoxing Stomatological Hospital,Shaoxing 312000,Zhejiang Province,China;Department of Prosthodontics,Shaoxing Stomatological Hospital,Shaoxing 312000,Zhejiang Province,China)

机构地区：[1]绍兴市口腔医院种植中心,绍兴312000 [2]绍兴市口腔医院口腔颌面外科,绍兴312000 [3]绍兴市口腔医院口腔修复科,绍兴312000

出　　处：《中国基层医药》2024年第10期1446-1450,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察种植体周围不同黏膜厚度对种植体边缘骨吸收的影响。方法回顾性分析2020年12月至2022年5月在绍兴市口腔医院就诊的单牙种植固定修复患者75例的临床资料,根据种植体周围黏膜厚度分为薄龈组(n=40)和厚龈组(n=35)。在薄牙龈组,40颗种植体植入骨面下1.5 mm处;在厚牙龈组,35颗种植体植入骨面处。观察比较两组患者种植体存活率,种植体边缘骨吸收、骨改建情况,不良反应发生率。结果薄龈组的种植体存活成功率为75.00%(30/40),明显低于厚龈组的94.29%(33/35)(χ^(2)=5.17,P<0.05)。负重后9个月,薄龈组的种植体边缘骨吸收值为(0.16±0.04),高于厚龈组的(0.14±0.02);薄龈组的骨改建值为(1.03±0.21),低于厚龈组的(1.25±0.34),两组比较,差异均有统计学意义(t=2.83、3.48,均P<0.05)。薄龈组感染、出血、咬颌无力、疼痛等不良反应发生率为25.00%(10/40),高于厚龈组的5.72%(2/35)(χ^(2)=5.17,P<0.05)。结论黏膜厚度≥3 mm、种植体植入骨面下的种植体存活成功率更高,可以更好地维持骨组织的稳定性,减少骨吸收,增加骨改建、减少不良反应发生率。Objective To investigate the effect of mucosal thickness around implants on marginal bone resorption.Methods A retrospective analysis was conducted on the clinical data of 75 patients who received single-tooth implant restorations at Shaoxing Stomatological Hospital from December 2020 to May 2022.The patients were divided into two groups based on mucosal thickness:the thin gingiva group(n=40)and the thick gingiva group(n=35).In the thin gingiva group,implants were placed 1.5 mm below the bone surface,while in the thick gingiva group,implants were placed at the bone surface.Implant survival rates,marginal bone resorption,bone remodeling,and the incidence of adverse reactions were compared between the two groups.Results The implant survival rate in the thin gingiva group was significantly lower than that in the thick gingiva group[75.00%(30/40)vs.94.29%(33/35),χ^(2)=5.17,P<0.05].After 9 months of weight bearing,marginal bone resorption value in the thin gingiva group was significantly higher than that in the thick gingiva group[(0.16±0.04)vs.(0.14±0.02),t=2.83,P<0.05].The bone remodeling value in the thin gingiva group was significantly lower than that in the thick gingiva group[(1.03±0.21)vs.(1.25±0.34),t=3.48,P<0.05].The incidence of adverse reactions including infection,bleeding,occlusal weakness,and pain in the thin gingiva group was significantly higher than that in the thick gingiva group[25.00%(10/40)vs.5.72%(2/35),χ^(2)=5.17,P<0.05].Conclusion A mucosal thickness of≥3 mm is associated with a higher survival rate of implants placed below the bone surface,which better maintains bone tissue stability,reduces bone resorption,promotes bone remodeling,and decreases the incidence of adverse reactions.

关 键 词：牙种植体 单牙 牙龈 假体和植入物 骨质吸收 影响因素分析 

分 类 号：R783.6[医药卫生—口腔医学]