拔牙位点保存在慢性牙周炎患者前牙美学区拟拔除患牙中的应用

doi:10.12337/zgkqzzxzz.2025.10.004

摘要/Abstract

摘要： 目的评价拔牙位点保存在Ⅲ或Ⅳ期C级牙周炎患者前牙美学区患牙拔除中的应用效果。方法选取2022年1月至2024年6月在河南大学赛思口腔医院就诊因慢性牙周炎拟行前牙美学区患牙拔除的80例患者,其中试验组纳入40例患者,微创拔牙后行拔牙位点保存;对照组纳入40例患者,仅行微创拔牙。比较2组患者治疗前后的牙槽骨三维轮廓变化及治疗后疼痛的视觉模拟评分（VAS）。结果术后6个月与术后即刻的CBCT测量结果相比,试验组和对照组的牙槽骨垂直向高度均降低,但试验组的降低程度显著小于对照组（P=0.0060）;在距术后即刻牙槽嵴顶2 mm处的牙槽骨水平向宽度上,2组均有吸收,但试验组的吸收程度显著小于对照组（P=0.0008）;在距术后即刻牙槽嵴顶4 mm处的牙槽骨水平向宽度上,2组均增加,且试验组显著大于对照组（P=0.0390）。随着时间的延长,2组患者的VAS均呈下降趋势。术后3 d和7 d时,试验组的VAS均显著低于对照组（术后3 d时P=0.0007,术后7 d时P=0.0050）,差异具有统计学意义。结论拔牙位点保存可显著减少慢性牙周炎患者上颌前牙拔牙后的牙槽骨高度和宽度吸收,这可为后续种植修复提供良好的牙槽骨条件,同时能减轻患者的术后疼痛。

关键词: Ⅲ或Ⅳ期C级牙周炎, 拔牙位点保存, 微创拔牙

Abstract: Objective To evaluate the effect of extraction site preservation in the maxillary anterior aesthetic zone of patients with StageⅢ orⅣ, Grade C periodontitis. Methods A total of 80 patients who were required extraction of anterior maxillary teeth due to chronic periodontitis and were treated at Saisi Stomatological Hospital of Henan University from January 2022 to June 2024 were retrospectively included. Among them, 40 patients were assigned to the experimental group and underwent minimally invasive extraction followed by extraction site preservation, while 40 patients were assigned to the control group and underwent only minimally invasive extraction. Changes in the three-dimensional contour of the alveolar bone before and after treatment, as well as postoperative pain assessed by the visual analogue scale (VAS), were compared between the two groups. Results At 6 months postoperatively, compared with the immediate postoperative CBCT measurements, the vertical height of the alveolar bone decreased in both groups, but the decrease was significantly less in the experimental group than in the control group (P=0.0060). At 2 mm apical to the alveolar crest, both groups exhibited horizontal bone resorption, but the experimental group showed significantly less resorption (P=0.0008). At 4 mm apical to the alveolar crest, both groups showed an increase in horizontal bone width, with the experimental group showing a significantly greater increase than the control group (P=0.0390). Over time, VAS pain scores decreased in both groups. At 3 days and 7 days postoperatively, VAS scores in the experimental group were significantly lower than those in the control group (3 days: P=0.0007; 7 days: P=0.0050). Conclusion Extraction site preservation can significantly reduce the resorption of alveolar bone height and width following extraction of anterior maxillary teeth in patients with chronic periodontitis, thereby providing favorable conditions for subsequent prosthetic rehabilitation. In addition, it can alleviate postoperative pain.

Key words: StageⅢ orⅣ,Grade C periodontitis, Extraction site preservation, Minimally invasive tooth extraction

刘建兴,付焱,刘珂兆,等. 拔牙位点保存在慢性牙周炎患者前牙美学区拟拔除患牙中的应用[J]. 中国口腔种植学杂志, 2025, 30(5): 449-455. DOI: 10.12337/zgkqzzxzz.2025.10.004

Liu Jianxing, Fu Yan, Liu Kezhao, Zhang Wei. Application of extraction site preservation in the anterior aesthetic zone of patients with chronic periodontitis scheduled for tooth extraction[J].Chinese Journal of Oral Implantology, 2025, 30(5): 449-455.DOI: 10.12337/zgkqzzxzz.2025.10.004.

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