摘要
目的 探讨美学区单颗牙缺失即刻种植与拔牙位点保存后延期种植的临床效果.方法 选取在郑州植得口腔医院种植科2021年1月至2022年9月就诊的上颌前牙美学区单颗牙缺失需行种植修复的90例患者,按是否行拔牙位点保存及种植时机将患者分为即刻种植组与拔牙位点保存组,每组45例.即刻种植组采用即刻种植即刻修复,拔牙位点保存组采用拔牙位点保存后延期种植即刻修复.分析比较2组患者的牙槽骨相关指标、美学效果评价[红色美学评分(pink esthetic score,PES)与白色美学评分(white esthetic score,WES)]、炎症因子水平[C反应蛋白(C-reactive proten,CRP)与肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]及患者满意度评价.结果 种植体植入6个月后,2组患者的牙槽骨高度、宽度及密度与种植体植入即刻相比均降低(P<0.05),即刻种植组均高于拔牙位点保存组(P<0.05);种植体植入1个月后,2组患者的CRP与TNF-α均较种植体植入次日升高(P<0.05),而即刻种植组的CRP与TNF-α均低于拔牙位点保存组(P<0.05);永久修复6个月后,即刻种植组患者的唇侧黏膜曲度、唇侧黏膜高度、软组织颜色、软组织质地评分及PES总分均高于拔牙位点保存组(P<0.05);永久修复6个月后,即刻种植组患者修复体的形状、表面纹理评分及WES总分均高于拔牙位点保存组(P<0.05);即刻种植组患者的种植体周角化黏膜高度、美观度及咀嚼功能的满意度评分均高于拔牙位点保存组(P<0.05).结论 即刻种植与拔牙位点保存后延期种植对美学区单颗牙缺失患者均有良好的效果,但即刻种植对改善患者的牙槽骨质量、口腔美学效果、炎症状况及满意度方面效果更具优势.
Abstract
September 2022 at the Implant Department of Zhengzhou Zhide Stomatology Hospital. Based on the use of alveolar ridge preservation and timing of implantation,the patients were divided into two groups:the immediate implantation group (n=45) and the alveolar ridge preservation group (n=45). The immediate implantation group underwent the immediate implant placement and restoration,while the alveolar ridge preservation group received delayed implantation after ridge preservation,followed by immediate restoration. Alveolar bone-related parameters,inflammatory markers[C-reactive protein (CRP) and tumor necrosis factor-alpha(TNF-α)],aesthetic outcomes[pink esthetic score (PES) and white esthetic score (WES)],and patient satisfaction were analyzed and compared between the two groups. Results After 6 months of implant restoration,both groups showed reductions in alveolar bone height,width,and density compared to baseline (P<0.05);however,the immediate implantation group exhibited higher values than the alveolar ridge preservation group (P<0.05). One month post-restoration,CRP and TNF-α levels increased in both groups compared to baseline (P<0.05),but levels in the immediate implantation group were significantly lower than in the alveolar ridge preservation group (P<0.05). After 6 months of permanent restoration,the immediate implantation group demonstrated superior outcomes in lip-side gingival contour,gingival height,soft tissue color,texture,and PES total scores compared to the alveolar ridge preservation group (P<0.05). Similarly,crown profile,surface texture scores,and WES scores were higher in the immediate implantation group (P<0.05). Patient satisfaction regarding gingival attachment height,aesthetics,and masticatory function was also higher in the immediate implantation group (P<0.05). Conclusion Both immediate implantation and delayed implantation following alveolar ridge preservation are effective for treating single-tooth loss in the aesthetic zone. However,immediate implantation demonstrates greater advantages in improving alveolar bone quality,oral aesthetics,inflammation responses,and patient satisfaction.
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