穿龈式非翻瓣微创种植术临床应用

Clinic application of flapless access directly through the gingival in implant surgery

目的:推荐一种穿龈式非翻瓣微创种植术式,更好地普及和推广种植技术。方法:30例(30枚种植体)随机分为穿龈式非翻瓣组(穿龈组)和环切法非翻瓣组(环切组)。穿龈组:黏骨膜刻度探针测量种植区软组织厚度,结合CBCT或口腔全景片了解牙槽骨厚度。在获得软硬组织测量数据后,采用有刻度标识的先锋钻制备种植窝洞,常规扩孔后植入种植体,抗生素生理盐水冲洗窝洞,派利奥缓释剂封闭种植创口。一期法手术,无需缝合和拆线。环切组:环切刀切除种植区黏骨膜组织,其余步骤同穿龈组。结果:穿龈组术后创口无出血、无水肿、无感染,多数患者勿需口服抗菌药物。无1例种植体周围炎发生。结论:穿龈式非翻瓣手术适用于牙间距较小的小直径种植体。该术式简单易行,术后反应小。经过15年随访,无1例患者发生种植体周围炎,X线检查显示全部病例均有良好的骨整合过程。

Objective：In this clinical study,we introduced a new implant surgery technique by flapless access directly though the gingival,for patients with narrow alveolar space,so as to reduce the surgical injury and make the implant surgery more widely applicable. Method：All 30 patients （30 implanls） were divided into two group. In group of directly drilling：depth of soft tissue around implant area was measured by special periodontic probe. Hard tissue was examined by CBCT or oral panoramic film.According to length of soft tissue and hard tissue,special pilot drill was used to ,,lake the hole of implant. Af- ter the hole be made,0.9 % NS with gentamycine was used to wash the hole,in order to push the remained epithelium out. Periocline conorolled gel was put to seal soft wound . Incision was not be sutured.In group of punch：access was made by trephine,other technique were as before. Result：In 30 implants,no bleeding and inflammation were found in group of directly drilling. Antibiotic was not necessary for most patients.No implantitis was occurred in this clinic observation. Conclusion：Ac- cess of drilling through gingival is a easy way for implant patients with narrow alveolar ridge. The advantages of this surgery is slight reaction. As 15 years fellow up,no implantitis was found in all cases.Ossto-intergration was occurred in every im- plants by x-ray examination.