不翻瓣微创法对口腔种植手术效果和牙槽嵴顶骨吸收的影响

Effects of flapless minimally invasive surgery on surgical results of oral implant and alveolar crest bone resorption

目的:探讨不翻瓣微创法对口腔种植手术效果、牙槽嵴顶骨吸收、美观度的影响。方法:将我院2016年6月~2018年6月收治的70例口腔种植患者分为观察组和对照组各35例。对照组患者予以传统翻瓣术,观察组患者予以不翻瓣微创术。比较两组患者手术相关指标手术时间、术后疼痛反应时间、术后抗生素应用时间、术后激素使用时间、术后疼痛评分[视觉模拟评分法(visual analogue scale,VAS)]、种植成功率、不良事件发生率和种植体稳定性差异,并观察手术前后满意度(美观效果、舒适度)评分变化情况。结果:观察组患者手术时间、术后疼痛反应时间、术后抗生素应用时间、术后激素使用时间均短于对照组,术后VAS评分低于对照组,种植成功率高于对照组,术后6个月牙槽嵴顶骨吸收量少于对照组(P<0.05)。两组患者不良事件发生率、术后3个月种植体稳定系数比较,差异无统计学意义(P>0.05)。术后3个月,两组患者在美观效果、舒适度2个方面的满意度评分均较术前升高,且观察组高于对照组(P<0.05)。结论:与传统翻瓣术比较,不翻瓣微创法可缩短手术时间,减轻术后疼痛,减少术后抗生素、激素用药时间,且种植成功率更高,种植体稳定性较好,骨吸收较少,同时具有良好的美观效果。

Objective:To investigate the effects of flapless minimally invasive surgery on surgical results of oral implant,alveolar crest bone absorption and aesthetics.Methods:Seventy patients with oral implant in our hospital from June 2016 to June 2018 were divided into observation group and control group by computerized random number method,with 35 cases in each group.Control group was given traditional flap surgery,and observation group was given flapless minimally invasive surgery.Surgery-related indicators including surgical time,postoperative pain response time,postoperative antibiotic application time,postoperative hormone application time,postoperative pain score of visual analogue scale(VAS),implant success rate,incidence rate of adverse events and implant stability were compared between the two groups,and the changes in scores of satisfaction(aesthetic effects,comfort)were observed before and after surgery.Results:The surgical time,postoperative pain response time,postoperative antibiotic application time and postoperative hormone application time in observation group were shorter,the postoperative VAS score was lower and the implant success rate was higher than that in control group.And the absorption volume of alveolar crest bone at 6 months after surgery was less than that in control group(P<0.05).There were no significant differences in the incidence rate of adverse events and implant stability coefficient at 3 months after surgery between the two groups(P>0.05).At 3 months after surgery,the satisfaction scores of two aspects of aesthetic effects and comfort in the two groups were higher than those before surgery,and the scores in observation group were higher than those in control group(P<0.05).Conclusion:Compared with traditional flap surgery,flapless minimally invasive surgery can shorten the surgical time,relieve postoperative pain,and reduce the postoperative antibiotic application time and hormone application time,and it has higher implant success rate,better implant stability,less bone absorption and better aesthetic effects.