即刻种植翻瓣与不翻瓣术临床疗效分析

doi:10.19438/j.cjoms.2020.02.011

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (2): 144-147.doi: 10.19438/j.cjoms.2020.02.011

即刻种植翻瓣与不翻瓣术临床疗效分析

孙亮¹, 曲哲²

1.大连医科大学大连市口腔医院研究生培养基地种植科,辽宁大连 116021;
2.大连市口腔医院种植科,辽宁大连 116021

收稿日期:2019-06-17 修回日期:2019-08-13 出版日期:2020-03-20 发布日期:2020-04-30
通讯作者: 曲哲,E-mail：quzhekq@outlook.com
作者简介:孙亮（1992-）,男,住院医师,E-mail：761370830@qq.com

Study on clinical effectiveness between flap and flapless immediate implant placement

SUN Liang¹, QU Zhe²

1.Resident Training Center for Dental Implantation, Dalian Stomatological Hospital, Dalian Medical University. Dalian 116021, Liaoning Province;
2.Department of Implantation, Dalian Stomatological Hospital. Dalian 116021, Liaoning Province, China

Received:2019-06-17 Revised:2019-08-13 Online:2020-03-20 Published:2020-04-30

摘要/Abstract

摘要： 目的:评估即刻种植中翻瓣或不翻瓣手术唇侧骨板骨吸收量、种植体留存率、软组织得分,为临床选择不同的术式提供参考。方法:选取上颌前牙即刻种植的42例患者作为研究对象,分为翻瓣组（22例、24颗种植体）和不翻瓣组（20例、22颗种植体）。应用Mimics软件,通过拟合,比较患者术后当天和术后6个月局部骨量。采用SPSS 20.0软件包分析种植术后6个月时的骨吸收量平均值和方差,统计种植体留存率。于永久修复后2年,对2组患者的粉色美学指数（pink esthetic score, PES）及牙龈乳头指数（papilla index score, PIS）进行评分。结果:翻瓣组与不翻瓣组种植体平台（种植体颈部平台）、中部（种植体长度1/2）、根尖点（种植体最底端）种植术后6个月的骨吸收量分别为（0.591±0.604）、（1.145±0.923）、（0.951±1.092）mm和（0.384±0.321）、（0.469±0.321）、（0.209±0.288）mm。种植体中部及根尖点骨吸收量具有显著差异,种植体颈部骨吸收量无显著差异。2组种植体在观察期内无一脱落,种植体存留率为100%。翻瓣组（19例）及不翻瓣组（18例）单颗种植冠的PES及PIS得分分别为（7.34±1.132）、（8.04±0.631）和（2.04±0.591）、（2.41±0.254）,差异无统计学意义。结论:即刻种植时翻瓣与不翻瓣相比,种植体边缘骨水平均相对稳定,不翻瓣组骨吸收低于翻瓣组。永久修复后2年,两者的PES、PIS无显著差异。

关键词: 即刻种植, 翻瓣, 不翻瓣, 美学, 上颌前牙

Abstract: PURPOSE： This study evaluated bone absorption, implant retention and soft tissue score of the labial bone plate in immediate dental implantation with or without flaps, and provide some guidance for clinical selection of different surgical methods. METHODS: Forty-two patients with immediate dental implantation of maxillary anterior teeth were selected as the subjects of this study. They were divided into flap group (22 cases) with 24 implants and flapless group (20 cases) with 22 implants. Mimics software was used to fit and compare the local bone mass of the patients on the day of operation and 6 months after operation. SPSS 20.0 software package was used to analyze the mean and variance of bone absorption 6 months after implantation, and the retention rate of implants was calculated. Pink esthetic score (PES) and papilla index score(PIS) of the two groups were compared 2 years after permanent restoration. RESULTS: The bone resorption of implant plateau (implant neck plateau), middle (implant length 1/2) and apical (implant lowest end) 6 months after implantation were (0.591±0.604), (1.145±0.923), (0.951±1.092), (0.384±0.321), (0.469±0.321), (0.209±0.288)mm, respectively. There was no significant difference in bone resorption in the middle part of implant and apical bone, except in the neck of implant. The implants in the flap group and the flapless group did not fall off during the observation period, and the implant retention rate was 100%. The pink aesthetic index and gingival papilla index of single tooth in the flap group (19 cases) and the flapless group (18 cases) were (7.34±1.132), (8.04±0.631); (2.04±0.591), (2.41±0.254),respectively(P>0.05). CONCLUSIONS: Immediate implant with flap or flapless technique had relatively stable marginal bone levels. Bone resorption in flapless group was lower than that in flap group. There was no significant difference in PES, PIS and P values between the two groups 2 years after permanent repair, but long-term observation was still needed.

Key words: Immediate Implant, Flap, Flapless, Aesthetics, Anterior teeth

中图分类号:

R782.1

孙亮, 曲哲. 即刻种植翻瓣与不翻瓣术临床疗效分析[J]. 中国口腔颌面外科杂志, 2020, 18(2): 144-147.

SUN Liang, QU Zhe. Study on clinical effectiveness between flap and flapless immediate implant placement[J]. China J Oral Maxillofac Surg, 2020, 18(2): 144-147.

参考文献

[1] Schulte W, Kleineikenscheidt H, Lindner K, et al.The Tübingen immediate implant in clinical studies[J]. Dtsch Zahnärztl Z, 1978, 33(5): 348-359.
[2] Chen ST, Buser D.Clinical and esthetic outcomes of implants placed in postextraction sites[J]. Int J Oral Maxillofac Implants, 2009, 24(Suppl): 186-217.
[3] Araújo MG, Sukekava F, Wennström JL, et al.Tissue modeling following implant placement in fresh extraction sockets[J]. Clin Oral Implants Res, 2006, 17(6): 615-624.
[4] Kan JY, Rungcharassaeng K, Lozada JL, et al.Facial gingival tissue stability following immediate placement and provisionalization of maxillary anterior single implants: a 2- to 8-year follow-up[J]. Int J Oral Maxillofac Implants, 2011, 26(1): 179-187.
[5] Buser D, Chappuis V, Belser CU, et al.Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late?[J]. Periodontology 2000, 2017, 73(1): 84-102.
[6] Blanco J, Nuñez V, Aracil L, et al.Ridge alterations following immediate implant placement in the dog: flap versus flapless surgery[J]. J Clin Periodontol, 2010, 35(7): 640-648.
[7] 岳嵚, 胡秀莲, 林野, 等. 上颌前牙翻瓣与不翻瓣即刻种植修复临床效果比较研究[J]. 中国实用口腔科杂志, 2015, 8(7): 410-414.
[8] Belser UC, Grütter L, Vailati F, et al.Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores[J]. J Periodontol, 2009, 80(1): 140-151.
[9] Jemt T.Regeneration of gingival papillae after single-implant treatment[J]. Int J Periodontics Restorative Dent, 1997, 17(4): 326-333.
[10] Capelli M, Testori T, Galli F, et al.Implant-buccal plate distance as diagnostic parameter: a prospective cohort study on implant placement in fresh extraction sockets[J]. J Periodontol, 2013, 84(12):1768-1774.
[11] Hu X, Nahles S, Nelson CA, et al.Analysis of soft tissue display during enjoyment smiling: part 1-caucasians[J]. Int J Periodontics Restorative Dent, 2013, 33(1): e9-e15.
[12] Hu X, Lin Y, Heberer S, et al.Analysis of soft tissue display in Chinese subjects during an enjoyment smile[J]. Quintessence Int, 2012, 43(2): 105-110.
[13] Sagirkaya E, Kucukekenci AS, Karasoy D, et al.Comparative assessments, meta-analysis, and recommended guidelines for reporting studies on histomorphometric bone-implant Contact in humans[J]. Int J Oral Maxillofac Implants, 2013, 28(5): 1243-1253.
[14] Lang NP, Pun L, Lau KY, et al.A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year[J]. Clinl Oral Implants Res, 2012, 23(Suppl 5): 39-66.
[15] 胡秀莲, 林野, 邸萍, 等. 应用异体脱细胞真皮基质关闭即刻种植软组织创面的临床研究[J]. 现代口腔医学杂志, 2009, 23(1): 6-9.
[16] 林野, 邱立新, 胡秀莲, 等. 硬腭结缔组织游离移植在上颌前牙区种植中的应用[J]. 北京大学学报(医学版), 2008, 40(1): 52-56.
[17] Paolantonio M, Dolci M, Scarano A, et al.Immediate implantation in fresh extraction sockets. a controlled clinical and histological study in man[J]. J Periodontol, 2001, 72(11): 1560-1571.
[18] 朱一博, 邱立新. 上颌切牙解剖分型与种植方案的选择[J]. 中华口腔医学杂志, 2013, 48(4): 223-225.
[19] 李瑶琴, 胡建, 汤春波. 不翻瓣对比翻瓣种植手术对牙列缺损患者即刻负重的影响:口内随机对照1年试验结果[J]. 中国口腔医学继续教育杂志, 2013, 13(1): 6-14.

即刻种植翻瓣与不翻瓣术临床疗效分析

Study on clinical effectiveness between flap and flapless immediate implant placement

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 14

编辑推荐

Metrics

本文评价

[1]	孙守福, 张莹, 赵昊明, 王文超, 魏文佳, 郭克. 数字化导板辅助下左上根折中切牙不翻瓣即刻种植即刻自体冠修复1例报告[J]. 中国口腔颌面外科杂志, 2023, 21(2): 197-202.
[2]	周亦凝, 顾迎新. “盾构术”应用于美学区种植的研究进展[J]. 中国口腔颌面外科杂志, 2022, 20(2): 198-201.
[3]	姚晨阳, 梅东梅, 滕敏华, 徐昊, 王文雪, 李晶, 周琛, 赵保东. 上颌前牙区根盾术即刻种植与常规即刻种植的临床效果评价[J]. 中国口腔颌面外科杂志, 2021, 19(6): 511-516.
[4]	李晶, 梅东梅, 姜雅萍, 徐昊, 王文雪, 姚晨阳, 李亚男, 赵保东. 2 mm矮愈合基台在前牙美学区早期种植骨增量中的效果分析[J]. 中国口腔颌面外科杂志, 2021, 19(6): 531-535.
[5]	姚晨阳, 梅东梅, 滕敏华, 徐昊, 王文雪, 李晶, 周琛, 赵保东. 上颌前牙区根盾术即刻种植与常规即刻种植的临床效果评价[J]. 中国口腔颌面外科杂志, 2021, 19(6): 536-541.
[6]	张楚南, 赵旭, 乔士冲, 张晓梦, 顾迎新. 拔牙窝内植入不同深度骨水平种植体周围软硬组织改建的组织形态变化[J]. 中国口腔颌面外科杂志, 2021, 19(3): 193-196.
[7]	秦坤, 刘红红, 章润宇, 张志宏. 引导骨再生术对前牙区种植牙龈美学及牙槽骨吸收的影响[J]. 中国口腔颌面外科杂志, 2020, 18(3): 236-239.
[8]	李敬华, 姜文静, 王艳辉, 李晓静, 柏娜. 下颌前牙唇侧骨壁厚度及倾斜角度对即刻种植术前设计的影响[J]. 中国口腔颌面外科杂志, 2019, 17(3): 230-234.
[9]	万绍楠, 杨驰, 浦益萍. 上颌前牙美学区牙槽骨骨量及形态的研究[J]. 中国口腔颌面外科杂志, 2019, 17(3): 240-246.
[10]	万绍楠, 浦益萍, 杨驰. 后牙区即刻种植与延期种植后牙槽骨吸收的影像学比较分析[J]. 中国口腔颌面外科杂志, 2019, 17(2): 150-154.
[11]	欧阳骞, 黄燕飞, 杨向红, 李德宏, 周静. 即刻种植联合组织清理术对犬种植体周围软组织形态的影响[J]. 中国口腔颌面外科杂志, 2018, 16(4): 334-337.
[12]	张楚南, 倪杰, 莫嘉骥, 乔士冲, 王蓓, 顾迎新. 美学区种植同期应用异种骨行引导骨再生术后愈合期间唇侧骨改建的临床研究[J]. 中国口腔颌面外科杂志, 2018, 16(1): 29-33.
[13]	罗蓉, 罗军, 黄彩红. 不翻瓣上颌前牙即刻牙种植术临床效果评价[J]. 中国口腔颌面外科杂志, 2017, 15(1): 69-72.
[14]	史俊宇, 赖红昌. 美学区种植修复的软组织稳定性研究进展[J]. 中国口腔颌面外科杂志, 2014, 12(1): 87-90.