[Evaluation of immediate implant in patients with limited buccal bone wall dehiscence in single upper anterior tooth].

抄録

To compare and evaluate the clinical outcome of immediate implant therapy in patients with limited buccal bone wall dehiscence and in patients with intact buccal bone wall. This prospective cohort study included patients intended to receive immediate implant treatment in upper anterior esthetic region in the Department of Implantology, Hospital of Stomatology, Wuhan University from August to December, 2018. Patients with buccal bone wall dehiscence limited to the coronal half were attributed to experimental group to conduct flap implant surgery (indicating to less than coronal half of the buccal bone wall length from the alveolar bone crest to the implant tip), whereas patients with intact buccal bone wall were attributed to control group to conduct flapless implant surgery. Buccal bone wall resorptions in height and thickness were evaluated 6 months after implant placement. Implant survival rate, pink/white esthetic score and post-operation complications were also analyzed 12 months after implant placement. Paired -test and two-sample -test were adopted to analyze the differences of different points within one group and differences between groups, respectively. A total of 38 patients with the age of (39.2±5.8) years (range 19-45 years) and 38 upper anterior single tooth implants were included,in which 19 patients were attributed to experimental group [12 male and 7 female, the age was (37.6±5.3) years], and 19 patients were attributed to control group [9 male and 10 female, the age was (40.8±6.7) years]. Over the 12 months' observation after implant placement, the overall implant survival rate was 97% (37/38), and 18/19 in control group and 19/19 in experimental group. Only one implant lost in control group and no other complications were reported. Buccal bone resorption in thickness and height occurred in both groups within 6 months after implant placement. The thickness and height of buccal bone decreased significantly in both groups within 6 months after implant placement (<0.05). Thickness decreases in experimental group were (1.32±0.74), (0.53±0.89) and (0.36±0.70) mm in coronal, middle and apical part of implant in experimental, and (1.24±0.57), (0.83±0.46) and (0.38±0.72) mm in coronal, middle and apical part of implant in control group. While the buccal bone height decreases were (0.24±0.15) mm in experimental group and (0.25±0.23) mm in control group. There were no statistical differences between the corresponding spots in the two groups (>0.05). Upon the final restoration, both group got ideal pink esthetic scores [experimental group (10.92±1.13),control group (10.92±1.26)] and white esthetic scores [experimental group (7.61±0.78), control group (7.40±0.71)], the differences in both groups were not statistically significant (>0.05). Clinical results of immediate implant to patients with buccal bone wall dehiscence limited to the coronal half are comparable to the results of patients with intact buccal bone wall.

对比评价单颗上前牙唇侧骨壁局限性骨缺损位点与唇侧骨壁完整位点的即刻种植效果。 选取2018年8至12月于武汉大学口腔医学院种植科就诊、拟行单颗上前牙即刻种植修复的患者，进行前瞻性队列研究。将存在唇侧骨壁冠方缺损且缺损不超过唇侧骨壁高度1/2（即从牙槽骨顶到种植体根尖对应的唇侧骨壁长度的1/2）的患者纳入试验组，进行翻瓣即刻种植；以唇侧骨壁完整的患者为对照组，进行不翻瓣即刻种植。种植体植入6个月后评价两组唇侧骨壁高度和厚度变化量，种植体植入12个月后评价种植体存留率、术后并发症以及粉白美学指数。使用配对检验和两样本检验分别比较同组不同时间点间差异和相同时间点组间差异。 共纳入单颗上前牙即刻种植患者38例，年龄（39.2±5.8）岁（19~45岁），植入38枚种植体；试验组19例，男性12例，女性7例，年龄（37.6±5.3）岁；对照组19例，男性9例，女性10例，年龄（40.8±6.7）岁。种植体植入后12个月内种植体存留率为97%（37/38），对照组种植体存留率为18/19，试验组为19/19。仅1枚对照组种植体脱落，其余种植体均无并发症。与术后即刻相比，两组患者唇侧骨壁术后6个月内均发生吸收，骨壁厚度和高度均显著减小（<0.05），试验组唇侧骨壁冠方、中部和根尖的厚度分别减小（1.32±0.74）、（0.53±0.89）和（0.36±0.70） mm，高度减小（0.24±0.15） mm；对照组唇侧骨壁冠方、中部和根尖的厚度分别减小（1.24±0.57）、（0.83±0.46）和（0.38±0.72） mm，高度减小（0.25±0.23） mm，两组差异均无统计学意义（>0.05）。完成永久修复时，两组均有良好的粉色美学指数评分［试验组（10.92±1.13）分、对照组（10.92±1.26）分］和白色美学指数评分［试验组（7.61±0.78）分，对照组（7.40±0.71）分］，两组差异均无统计学意义（>0.05）。 在唇侧骨壁缺损不超过唇侧骨壁高度1/2的位点进行即刻种植可获得与唇侧骨壁完整位点即刻种植相似的短期效果。.