三壁骨缺损中两种拔牙位点保存方法的对比研究

Comparative study of two methods for preserving extraction sockets with three-wall bone defects

目的:分析评价两种不同拔牙位点保存方法对三壁骨缺损拔牙窝的牙槽美学效果及牙槽骨变化的影响。方法:选择因无法保留而需要拔除的上前牙及上颌前磨牙18颗,微创拔除后分别行翻瓣的GBR位点保存术(A组)和不翻瓣的位点保存术(B组),观察术后软组织愈合情况、术后5个月牙槽美学效果和牙槽骨吸收情况。结果:(1) A组术后软组织愈合良好,B组初期软组织未全关闭。(2) A组的牙槽美学效果优于B组(P<0.05)。(3) A组牙槽骨高度增加7.33±0.21mm,B组牙槽骨高度增加4.02±0.31mm,两组差异有统计学意义(P<0.05);A组牙槽骨宽度减少0.47±0.14mm,B组牙槽骨宽度减少2.25±0.62mm,两组差异有统计学意义(P<0.05)。结论:上前牙及上颌前磨牙拔牙窝呈三壁骨缺损时,翻瓣的GBR位点保存术临床效果优于不翻瓣的位点保存术。

Objective:To analyze and evaluate the effects of two different extraction site preservation methods on the aesthetic effect of alveolar bone and alveolar bone resorption in the sockets with three-wall bone defects. Methods: 18 cases of minimally invasive extraction were selected. They were divided into 2 groups: GBR site preservation with flap(group A), site preservation with flapless(group B). Observe the soft tissue healing after surgery, the aesthetic effect of alveolar surgery at 5 months after surgery and alveolar bone resorption. Results:(1)The soft tissue in group A healed well after surgery, but the soft tissue in group B was not completely closed in the early stage.(2)The alveolar aesthetic effect of group A was better than that of group B(p<0.05).(3)The increased height of alveolar bone in group A was7.33±0.21 mm, in group B was 4.02±0.31 mm. There were significant differences between the two groups(p <0.05). The reduced width of alveolar bone in group A was 0.47 ±0.14 mm, in group B was 2.25 ±0.62 mm. There were significant differences between the two groups(p<0.05). Conclusion: When the extraction sockets were three-wall bone defects in the anterior area and maxillary premolars area, the clinical effect of GBR site preservation with flaps was better than site preservation with flapless.