上颌前牙不翻瓣即刻种植即刻修复的3 年回顾性研究

doi:10.12337/zgkqzzxzz.2019.12.008

摘要/Abstract

摘要： 目的: 研究上颌前牙不翻瓣即刻种植即刻修复的软硬组织稳定性。方法: 上颌前牙不翻瓣即刻种植即刻修复病例26例,当天行数字化扫描制作临时修复体,6个月个性化取模全瓷冠修复。对照组选取口内同名健康牙,种植术后1、3、6、12、24、36个月随访,评测探诊深度(PD)、改良菌斑指数(mPLI)、改良龈沟出血指数(mBI)、牙龈位置变化、边缘性骨吸收(MBL)。结果: 26枚种植体均获得了良好的软硬组织效果,种植体留存率100%。PD、mPLI、mBI值1、3、6个月时均高于天然牙,有显著性差异(P< 0.05),mBI值36个月也高于天然牙,有显著性差异。种植体周围牙龈前3个月内退缩0.31mm,3-6个月期间生长0.05mm,三年牙龈退缩0.36mm,近远中牙龈乳头较牙龈缘吸收少。种植体边缘骨吸收在术后3个月内骨吸收约0.81mm,一年时吸收0.97mm,之后每年吸收< 0.2mm。结论: 3年回顾性研究表明:上颌前牙不翻瓣即刻种植即刻修复可获得良好的软硬组织效果,值得临床推广。

关键词: 即刻种植, 即刻修复, 组织工程生物材料, 边缘性骨吸收, 回顾性研究

Abstract: Objective: To study the soft and hard tissue stability of flapless immediate implant and immediate restoration of single tooth in maxillary aesthetic area. Methods: 26 single implants in maxillary aesthetic area were included. All of the implants were placed immediately into fresh extractions and and immediately restoration, digital scanning to make temporary restorationsimmediately,The final restorations were performed after 6 months with all-ceramic crown, Control group selected intraoral dental health with the same name. On different time of follow-up, observation of probing depth(PD), modified plaque index (mPLI), modified sulcus bleeding index(mBI), gingival position, marginal bone loss. Results: The 26 implants were obtained the good stability of the soft and hard tissue and the aesthetic effect. The survival rate of both groups were 100%. The PD、mPLI、mBI value of 1, 3, 6, months was significantly higher than that of natural teeth, there was a significant difference(P<0.05), The mBI value of 36 months as significantly higher than that of natural teeth, there was a significant difference(P<0.05). The peri implant gingival degenerate 0.31mm the first 3 months than preoperative, gingival growth 0.05mm in 3-6 months, three years of gingival recession 0.36mm,midfacial papillaloss more than the distal or mesial papilla. Peri implant marginal bone loss 0.81mm with in three months after operation, Absorbed 0.97mm at 1 year. Conclusion: Flapless immediate implant and immediate prosthesis can maintain good soft and hard tissue stability, it was worth clinical promotion.

Key words: immediate implant, immediate prosthesis, tissue Engineering biomaterials, marginal bone loss, retrospective study

中图分类号:

R782.1

张宾,孙丽华,张俊花,等. 上颌前牙不翻瓣即刻种植即刻修复的3 年回顾性研究[J]. 中国口腔种植学杂志, 2019, 24(4): 178-183. DOI: 10.12337/zgkqzzxzz.2019.12.008

ZHANG Bin, SUN Lihua, ZHANG Junhua, et al. A retrospective study of flapless immediate implant and immediate restoration of single tooth in maxillary aesthetic area in 3 years[J].Chinese Journal of Oral Implantology, 2019, 24(4): 178-183.DOI: 10.12337/zgkqzzxzz.2019.12.008.

参考文献

[1] Branemark. PI.Osseo integration and its experimental background. J Prosthetdent, 1983, 50 : 399-410
[2] 谢艳婷, 江鹭鹭, 何晶, 等. 美学区单颗牙即刻种植和延期种植的短期红色美学和种植体边缘骨吸收的临床效果比较及影响因素分析[J]. 上海口腔医学, 2019, 28(02): 148-153
[3] Errus J, Cecchinato D, PjetuMn EB, et a1. Factors influencing ridge alterations following immediate implant placement into extraction sockets Clin Oral Implants Res,2010,21(1) :22-29
[4] Degidi M, Daprile G, Piattelli A.Primary Stability Determination by means of Inserion Torque and RFA in a Sample of 4, 135 implant. Clin implant Dent Relat Res, 2010
[5] De Rouck T, Collys K, Cosyn J.Immediate singletooth implants in the anterior maxilla: a 1-year case cohort study on hard and soft tissue response[J]. Journal of Clinical Periodontology, 2008, 35(7): 649-657
[6] Mombelli A, Oosten M A C, Schürch E, et al. The microbiota associated with successful or failing osseointegrated titanium implants[J]. Oral microbiology and immunology, 1987, 2(4): 145-151
[7] Albrektsson T, Zarb G, Worthington P, et al.The long-term efficacy of currently used dental implants: a review and proposed criteria of success[J]. International Journal of Oral & Maxillofacial Implants, 1986, 1(1)
[8] Chen S T, Buser D.Clinical and esthetic outcomes of implants placed in postextraction sites[J]. The International journal of oral & maxillofacial implants, 2009, 24 : 186
[9] Becker W, Goldstein M, Becker B E, et al.Minimally invasive flapless implant surgery: a prospective multicenter study[J]. Clinical implant dentistry and related research, 2005, 7(s1): s21-s27
[10] Botticelli D, Berglundh T, lindhe:Hard-tissue alterations following immediate implant placement in extraction sites.J Clin periodontol, 2004 : 820-828
[11] Josephy. k. kan, kitichai. rungcharassaeng, glenliddelow, etal.periimplant tissue response following immediate provisional restoration of scalloped implants in the esthetic zone.j the journal of prosthetic dentistry, 2007, 0022-3913
[12] Blanco J, Nunez V, AracilL, et al. Ridge alterations following immediate implant placement in the dog: flap versus flapless surgery. J Clin Periodontol, 2008, 107 : 197-203
[13] Arau jo MG. Lindhe J : Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol, 2005, 32 : 212-218
[14] Novaes Jr. Raquel R.M. de Barros.Vula Papalexiou e colbs.Buccal bone remodeling after immediate implantation with a flap or flapless Approach : A Pilot Study in Dogs. Titanium 2009, 1 : 45-51
[15] Campelo LD, Camara JR.Flapless implant surgery:a 10-year clinical retrospective analysis. Int J OralMaxillofac Implants, 2008, 17(2): 271-276
[16] Becker W, Goldstein M, Becker BE.et al.Minimally invasive flapless implant surgery: a prospective multicenter study[J]. ClinImplant Dent Relat Res, 2005,7(1): 21-27
[17] 孙晓琳, 周延民, 赵静辉, 等. PRF在前牙即刻种植修复中的应用[J]. 实用口腔医学杂志, 2018, 34(01):125-126
[18] Udatta Kher, Ali Tunkiwala, Siddarth Shanbag.A graftless socket-shield technique for immediate implant placement in the esthetic zone[J]. Clinical Oral Implants Research, 2018, 29
[19] 高旭, 刘梅, 刘翠玲. 种植义齿排龈后种植体周围软组织损伤愈后的动物实验研究[J]. 华西口腔医学杂志, 2018, 36(03): 287-290
[20] Grunder U.Stability of the mucosal topography around single-tooth implants and adjacent teeth : 1-year results[J]. In J Periodontics Restorative Dent, 2000, 20(1): 11-17
[21] Brunski JB.Avioid pitfalls of overloading and micromtion of intraosseous implants.Dent Implantol Update, 1993, 4(10): 77-81
[22] Meyer U, Wiesmann HP, Fillies T, et al.Early tissue reaction at the interface of immediately loaded dental implants. Int J Oral maxillofac Implants, 2003, 18(4): 489-499
[23] Abboud M, Koeck B, Stark H, et al.Immediate loading of single-tooth implants in the posterior region[J]. Journal of Prosthetic Dentistry, 2005, 94(2): 198-198
[24] Elisabeth, Reiger, Lucia.Hackermuller, Martin.Berninger, et al.Exploration of gold nanoparticle beams for matter wave interferometry. J Optics Communications, 2006, 264 : 326-332
[25] Evans C D J, Chen S T. Esthetic outcomes of immediate implant placements[J]. Clinical Oral Implants Research, 2008, 19(1): 73-80
[26] Mamatha. Siddalingappa, Yogish. Puttashamachari, Rithe.Immediate implant placement: A longitudinal study to assess soft and hard tissue[J]. Journal of Dental Implants, 2018, 8(2): 43-47. DOI : 10.4103/jdi.jdi_11_18