上颌前牙区不翻瓣即刻牙种植术对患者口腔内软硬组织的影响

Effect of immediate flapless dental implant surgery on the soft and hard tissues in the mouths of patients

目的分析上颌前牙区不翻瓣即刻牙种植术对患者口腔内软硬组织的影响。方法选择2010年3月至2013年3月在我院接受手术治疗的前牙或者前磨牙修复患者100例作为研究对象。以数字法随机分成观察组和对照组各50例。对照组实施翻瓣的即刻牙种植手术,观察组则实施不翻瓣的即刻牙种植手术,统计并对比两组术后整体情况、术后软硬组织情况,以及治疗前后的PES评分与VAS评分。结果观察组患者术后1 d的肿胀和疼痛率均明显低于对照组,而术后12个月的牙龈乳头指数明显高于对照组,差异均有统计学意义(P<0.05);两组患者术后12个月的骨愈合及牙龈沟出血方面比较差异均无统计学意义(P>0.05);观察组患者术后12个月的嵴顶吸收值明显少于对照组,差异有统计学意义(P<0.05);两组患者术后7 d的牙槽嵴顶和植体距离及术后12个月的牙龈沟深度比较差异均无统计学意义(P>0.05);两组治疗后的PES评分及VAS评分较治疗前均有上升,但观察组的上升程度明显高于对照组,差异有统计学意义(P<0.05)。结论在上颌前牙区实施不翻瓣的即刻牙种植手术,疗效更佳,更具美感,值得推广。

Objective To study the effect of immediate flapless dental implant surgery in maxillary anterior teeth area on the soft and hard tissues in the mouths of patients. Methods One hundred patients received front teeth or premolar repair in our hospital from March 2010 to March 2013 were selected as research objects, which were ran-domly divided into the observation group and control group according to random number table, each with 50 patients. The control group was treated with conventional flapped dental implant surgery, while the observation group was treat-ed with flapless dental implant surgery immediately. The postoperative overall situation, postoperative status of soft and hard tissues, and pink esthetic score （PES） and visual analogy score （VAS） before and after treatment were com-pared between the two groups. Results The rate of postoperative pain and swelling 1 d after surgery were signifi-cantly lower in the observation group than the control group, and gingival papilla index 12 months after surgery was significantly higher in the observation group, all with statistically significant differences （P〈0.05）. Bone healing and gingival sulcus bleeding 12 months after surgery showed no statistically significant difference between the two groups （P〉0.05）. The absorption value of crest 12 months after surgery was significantly less in the observation group than the control group （P〈0.05）. There was no statistically significant difference in alveolar ridge top and implant distance 7 d after surgery, gingival groove depth 12 months after surgery between the two groups （P〉0.05）. PES and VAS both increased after treatment compared with those before treatment, and the increase in the observation group was signifi-cantly higher than that in the control group, with statistically significant difference （P〈0.05）. Conclusion Applica-tion of immediate flapless dental implant surgery in maxillary anterior teeth area results in better curative effect and more aesthetic feeling, which is worth promoting.