摘要
目的 研究下颌后牙区即刻种植与延期种植的临床效果。方法 选取2020年3月至2022年3月于南京中医药大学附属中西医结合医院口腔科和徐州医科大学附属口腔医院就诊的下颌后牙区种植修复患者60例(60颗种植体),依据种植体植入时机将患者分为即刻组(30例,行即刻种植)和延期组(30例,行延期种植),均植入种植体30颗。比较2组患者的治疗周期,冠修复后1、3、6个月的牙周组织健康程度[探诊深度(probing depth,PD)、改良菌斑指数(modified plaque index,mPLI)及改良龈沟出血指数(modified bleeding index,mBI)],种植体植入术后3、6、12个月的近中与远中边缘骨及颊侧骨吸收情况,种植体植入术后12个月的牙槽嵴吸收情况,修复前的种植体稳定系数(implant stability quotient,ISQ),种植体植入术后12个月内的并发症发生情况和种植成功率。结果 即刻组患者的治疗周期为(6.13±0.35)个月,明显短于延期组[(9.13±0.35)个月],差异有统计学意义(t=33.605,P<0.001)。冠修复后1、3、6个月,2组患者的PD、mPLI、mBI比较,差异均无统计学意义(均P>0.05)。种植体植入术后3、6、12个月,2组患者的种植体边缘骨均表现为吸收,且其相同时间段内近中与远中边缘骨吸收量、颊侧骨板吸收量、颊侧骨板吸收率、颊侧骨体积吸收量及颊侧骨体积吸收率比较,差异均无统计学意义(均P>0.05)。种植体植入术后12个月,2组患者牙槽嵴各位点宽度和高度均有所下降,除位点1(种植体肩台处)即刻组牙槽嵴宽度吸收量与延期组比较差异有统计学意义(Z=2.167,P=0.030)外,其余位点牙槽嵴宽度及牙槽嵴高度的差异均无统计学意义(均P>0.05)。2组患者修复前的ISQ及种植体植入术后12个月的创口感染发生率比较,差异均无统计学意义(均P>0.05)。种植体植入术后12个月,即刻组种植体周炎7例,其发生率(23.33%)明显高于延期组[0例(0%)],差异有统计学意义(χ^(2)=5.822,P=0.016);2组种植成功率均为100%。结论 下颌后牙区即刻种植与延期种植治疗的临床效果均较佳,且即刻种植可有效缩短治疗周期。然而,即刻种植发生种植体周炎的风险较高,应积极控制易感因素,采取针对性防治措施。
Objective To study the clinical effects of immediate implantation and delayed implantation in the posterior mandibular region.Methods A total of 60 patients(60 dental implants)who underwent implant restoration in the posterior mandibular region at the Department of Stomatology,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,and the Affiliated Stomatological Hospital of Xuzhou Medical University between March 2020 and March 2022 were selected.According to the timing of implant placement,the patients were divided into immediate group(30 cases,immediate implantation)and delayed group(30 cases,delayed implantation).Totally 30 dental implants were used in each group.The two groups were compared in terms of treatment cycle,health degree of periodontal tissues[probing depth(PD),modified plaque index(mPLI)and modified bleeding index(mBI)]at 1 month,3 months and 6 months after crown restoration,mesial and distal marginal bone resorption and buccal bone resorption at 3 months,6 months and 12 months after implant placement,alveolar ridge resorption at 12 months after implant placement,implant stability quotient(ISQ)after surgery and before restoration,the occurrence of complications within 12 months after implant placement,and the success rate of implantation.Results Treatment cycle of the immediate group[(6.13±0.35)months]was significantly shorter than that of the delayed group[(9.13±0.35)months](t=33.605,P<0.001).There were no statistically significant differences in PD,mPLI,or mBI between the two groups at 1 month,3 months and 6 months after crown restoration(all P>0.05).At 3 months,6 months and 12 months after implant placement,implant marginal bone resorption was observed in both groups.There were no statistically significant differences in mesial and distal marginal bone resorption,buccal bone plate absorption,buccal bone plate absorption rate,buccal bone volume absorption,or buccal bone volume absorption rate between the two groups(all P>0.05).At 12 months after implant placement,there were decreases in alveolar ridge width and height at each site.There was a statistically significant difference in absorption of alveolar ridge width at site 1(shoulder of the implant)between the immediate group and the delayed group(Z=2.167,P=0.030);however,there was no statistically significant differences in alveolar ridge width and height at the other sites(all P>0.05).There were no statistically significant differences in ISQ after surgery and before restoration or in wound infection rate within 12 months after implant placement between the two groups(both P>0.05).The incidence rate of peri-implantitis in the immediate group within 12 months after implant placement[7 cases(23.33%)]was significantly higher than that in the delayed group[0 case(0%)](χ^(2)=5.822,P=0.016).The success rates of implantation in both groups within 12 months after implant placement reached 100%.Conclusion Immediate implantation and delayed implantation in the posterior mandibular region both can achieve good clinical effects,and the former can effectively shorten the treatment cycle.However,there is a higher risk of peri-implantitis after immediate implantation.Therefore,susceptible factors should be controlled actively,and targeted prevention and treatment measures should be taken.
作者
席云昊
冯岩
吴品林
张昕
耿晓庆
李晓飞
李长顺
XI Yun-hao;FENG Yan;WU Pin-lin;ZHANG Xin;GENG Xiao-qing;LI Xiao-fei;LI Chang-shun(Department of Stomatology,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210000,China;Department of Stomatology,Jiangsu Province Academy of Traditional Chinese Medicine,Nanjing 210000,China;不详)
出处
《中国实用口腔科杂志》
2025年第1期41-47,共7页
Chinese Journal of Practical Stomatology
基金
国家自然科学基金(82403500)
江苏省高等学校基础科学(自然科学)研究面上项目(1020241241)
徐州市卫生健康委员会项目(XWKYSL20220107)。
关键词
下颌后牙区
即刻种植
延期种植
治疗效果
posterior mandibular region
immediate implantation
delayed implantation
therapeutic effect
