上前牙即刻种植修复的美学效果及其对骨量与牙周组织健康的影响

doi:10.12337/zgkqzzxzz.2025.12.012

摘要/Abstract

摘要： 目的探究上前牙即刻种植修复的美学效果及其对骨量与牙周组织健康的影响。方法本研究采用前瞻性队列研究设计。连续纳入2023年1月至2025年1月在濮阳油田总医院口腔科因上颌前牙牙体严重缺损拟行种植修复的患者。根据患者意愿、自身条件及临床评估确定最终治疗方案,将患者分为2组：即刻种植组（n=55）,延期种植组（n=55）,对比2组在牙槽骨吸收指标、美学指标、患者主观满意度、牙周组织健康程度及并发症方面的影响。结果即刻修复后6个月,即刻种植组骨吸收量低于延期种植组（P<0.05）;永久修复6个月后,2组骨吸收量差异无统计学意义（P>0.05）。即刻修复后6个月,即刻种植组红色美学评分（PES）、视觉模拟评分（VAS）分值高于延期种植组（P<0.05）。术后1个月,即刻种植组牙周探诊深度（PD）低于延期种植组（P<0.05）,改良龈沟出血指数（mBI）高于延期种植组（P<0.05）;术后3个月、永久修复后6个月,2组PD值均较1个月时显著改善（P<0.05）,即刻种植组PD值低于延期种植组（P<0.05）,2组的mBI无统计学意义（P>0.05）,即刻种植组mBI值较术后1个月时显著降低（P<0.05）。即刻种植组并发症发生率低于延期种植组（P<0.05）。结论前牙缺失修复中,即刻种植与延期种植2种术式均可实现理想的长期美学修复效果,即刻种植能有效控制早期牙槽骨吸收程度,更有利于维持种植体周软组织稳定性,且早期美学表现及患者满意度更优,并能显著减少术后不良反应的发生风险。

关键词: 上前牙即刻种植修复, 美学效果, 骨量, 牙周组织健康

Abstract: Objective To investigate the aesthetic outcomes of immediate implant restoration in the maxillary anterior region and the impact on bone volume and periodontal tissue health. Methods This study adopted a prospective cohort study design. Patients who presented to the Department of Stomatology of Puyang Oilfield General Hospital between January 2023 and January 2025 with severe maxillary anterior tooth defects and who were scheduled for extraction followed by implant restoration were included in this study. Based on the patients' wishes, personal conditions, and clinical evaluation, the final treatment plan was determined. The patients were divided into two groups: those who received immediate implant restoration were included in the immediate implantation group (n=55), and those who received delayed implant restoration after tooth extraction site preservation were included in the delayed implantation group (n=55). The alveolar bone resorption indicators, aesthetic indicators, patient subjective satisfaction, periodontal tissue health, and complications were compared between the two groups. Results Six months after immediate restoration, the bone resorption in the immediate implantation group was lower than that in the delayed implantation group (P<0.05); six months after permanent restoration, there was no statistically significant difference in bone resorption between the two groups (P>0.05). Six months after immediate restoration, the pink esthetic score (PES) and visual analog scale (VAS) scores of the immediate implantation group were higher than those of the delayed implantation group (P<0.05). At 1 month postoperatively, the immediate implantation group had a lower probing depth (PD) but a higher modified sulcus bleeding index (mBI) than the delayed implantation group (P<0.05). At 3 months post-surgery and 6 months after permanent restoration, PD improved significantly in both groups compared with their 1-month values (P<0.05), with the immediate implantation group maintaining lower PD (P<0.05). No significant difference in mBI was observed between the two groups at 3 months post-surgery and 6 months after permanent restoration (P>0.05). The incidence of complications was lower in the immediate implantation group (P<0.05). Conclusion In anterior tooth restoration, both immediate implant placement and delayed implant placement can achieve ideal long-term aesthetic outcomes. Immediate implant placement effectively controls early alveolar bone resorption, better maintains peri-implant soft tissue stability, provides superior early aesthetic results and patient satisfaction, and significantly reduces the risk of postoperative adverse reactions.

Key words: Immediate implant restoration of maxillary anterior teeth, Aesthetic outcomes, Bone volume, Periodontal health

刘卿,林勇. 上前牙即刻种植修复的美学效果及其对骨量与牙周组织健康的影响[J]. 中国口腔种植学杂志, 2025, 30(6): 587-593. DOI: 10.12337/zgkqzzxzz.2025.12.012

Liu Qing, Lin Yong. Aesthetic outcomes of immediate implant restoration in the maxillary anterior region and its impact on bone volume and periodontal tissue health[J].Chinese Journal of Oral Implantology, 2025, 30(6): 587-593.DOI: 10.12337/zgkqzzxzz.2025.12.012.

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