种植修复单个上颌中切牙近中龈乳头高度的评估性研究

Assessment research on the inter-proximal mesial papilla height of single implant-supported maxillary central incisor

目的研究种植修复单个上颌中切牙近中龈乳头高度与手术前邻间接触区最低点到牙槽嵴顶的距离(CPB)的关系。方法选择56例上颌中切牙单个种植修复患者,拍摄上颌中切牙的数码根尖片,利用PlanmecaDimaxis Version 3.3.2软件分别测量手术前、手术后、修复前、修复后以及修复6个月后近中CPB,分析在整个种植修复过程中影响CPB的因素,并用统计软件SPSS 12.0对修复不同时期CPB与龈乳头高度之间的关系进行相关性分析。结果 56例患者中,当3 mm<CPB≤5 mm时,修复后有54.5%的龈乳头可恢复到良好,修复6个月后有95.5%的龈乳头可恢复到良好;当5 mm<CPB≤6 mm时,修复后及修复6个月后龈乳头恢复良好的概率分别为30.0%和75.0%;当CPB>7 mm时,几乎不可能恢复美观的龈乳头。CPB主要在手术后到修复前这段时间内发生变化,其变化范围为-0.13～0.46 mm。手术前CPB与修复6个月后龈乳头高度指数之间呈负相关,二者的相关系数r=-0.715(P<0.01)。结论手术前上颌中切牙邻面接触区最低点与邻近天然牙侧牙槽嵴顶间的距离可作为预测上颌中切牙种植修复后龈乳头高度恢复的重要参考指标之一。

Objective This prospective study was to observe the correlation between the mesial papilla’s height of single implant-supported maxillary central incisor and the distance from the base of the contact point to the alveolar bone crest.Methods 56 patients involved in single implant-supported maxillary central incisor were included in this study.The distances from the base of the contact point to the alveolar bone crest in the digital periapical film of maxillary central incisor were measured using the software Planmeca Dimaxis Version 3.3.2.The time of measurements were as follows： The pre-surgical and post-surgical periods,before and after the crown installation,the followup examination of more than 0.5 year.To analyze the factor of influencing distance,and the correlation between the distance and the height of gingival papilla during the whole restored period.Correlation analysis between the distance and the height of gingival papilla during the whole restoration was done by the statistical software SPSS 12.0.Results The results demonstrated that the ratio of esthetic papilla can achieve 54.5% at the crown installation and 95.5% at the follow-up examination when the distance was between 3 mm and 5 mm.When the distance was between 5 mm and 6 mm,they dropped to 30.0% and 75.0%,respectively.However,when the distance increased to above 7 mm,the papilla could hardly be in an esthetic outcome.There was a significant change of the distance was found during the periods from the post-surgery to pre-restoration,and the scope of the changes was between-0.13 mm and 0.46 mm.A negative correlation was found between the distance and the index of papilla.The correlation coefficient r was-0.715（P 0.01）.Conclusion It is proposed that the pre-surgery distance of maxillary central incisor from the base of the contact point to the alveolar bone crest can be used as one of the important reference indexes to assess and predict the height conditions of gingival papilla.