罹患重度牙周炎上颌磨牙拔牙微翻瓣牙槽嵴保存效果评价:一项回顾性初步研究  

Evaluation of micro crestal flap-alveolar ridge preservation in maxillary molar extraction for severe periodontitis:a retrospective study

作　　者：危伊萍 张浩筠 胡文杰[1] 徐涛[2] 李丽曼 赵丽萍 Wei Yiping;Zhang Haoyun;Hu Wenjie;Xu Tao;Li Liman;Zhao Liping(Department of Periodontology,Peking University School and Hospital of Stomatology&National Center for Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices,Beijing 100081,China;Department of Oral Emergency,Peking University School and Hospital of Stomatology&National Center for Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院牙周科、国家口腔医学中心、国家口腔疾病临床医学研究中心、口腔生物材料和数字诊疗装备国家工程研究中心,100081 [2]北京大学口腔医学院·口腔医院急诊科、国家口腔医学中心、国家口腔疾病临床医学研究中心、口腔生物材料和数字诊疗装备国家工程研究中心,100081

出　　处：《中国口腔种植学杂志》2024年第5期413-419,共7页Chinese Journal of Oral Implantology

基　　金：首都卫生发展科研专项项目(2022-2-4103);首都临床特色应用研究基金(Z161100000516042)。

摘　　要：目的采用临床回顾性研究的方式,探讨罹患重度牙周炎上颌磨牙拔牙微翻瓣牙槽嵴保存效果。方法纳入80例患者95颗上颌磨牙,拔牙后分别经过自然愈合或者微翻瓣牙槽嵴保存后种植,通过影像学评价骨高度、宽度变化和上颌窦气化量,记录种植时需要骨增量手术的比例。结果拔牙窝愈合后,牙槽窝中央骨高度在牙槽嵴保存组和自然愈合组分别增加了4.94 mm和2.20 mm。高骨壁侧嵴顶下1 mm骨宽度牙槽嵴保存组增加了约4 mm,而自然愈合组减少了约1 mm。自然愈合组上颌窦气化后的上颌窦底高度变化量为(0.50±0.35)mm,牙槽嵴保存组为(0.23±0.44)mm(P=0.003)。自然愈合组种植时骨增量比例为67.6%,牙槽嵴保存组为29.5%。结论罹患重度牙周炎上颌磨牙拔牙微翻瓣牙槽嵴保存可以改善牙槽骨高度、骨宽度及上颌窦气化,从而减少种植治疗阶段进行骨增量手术的比例,减少种植治疗阶段的创伤性和复杂性。Objective This retrospective clinical study aimed to investigate the effects of micro crestal flap-alveolar ridge preservation(MCF-ARP)following maxillary molar extraction in patients with severe periodontitis.Methods A total of 95 maxillary molars from 80 patients were included,with the teeth extracted and then either left to heal naturally or treated with MCF-ARP before implant placement.Changes in bone height,bone width,and maxillary sinus pneumatization were evaluated using imaging.Additionally,the proportion of patients requiring bone augmentation surgery during implant placement was recorded.Results After healing,the bone height at the center of the alveolar socket increased by 4.94 mm in the MCF-ARP group and 2.20 mm in the natural healing group.The bone width 1 mm below the crest of the ridge increased by about 4 mm in the MCF-ARP group,while it decreased by about 1 mm in the natural healing group.The maxillary sinus pneumatization was(0.50±0.35)mm in the natural healing group compared to(0.23±0.44)mm in the MCF-ARP group(P=0.003).The proportion of patients requiring bone augmentation during implant placement was 67.6%in the natural healing group compared to 29.5%in the MCF-ARP group.Conclusion In patients with severe periodontitis,MCF-ARP can improve alveolar bone height and width,as well as reduce maxillary sinus pneumatization.This technique decreases the need for bone augmentation surgery during implant placement,thereby reducing the trauma and complexity of the implant procedure.

关 键 词：磨牙 拔牙 牙周炎 拔牙位点保存 种植 

分 类 号：R783.6[医药卫生—口腔医学]