重度慢性牙周炎患者上颌磨牙区拔牙后即刻种植与位点保存术后延期种植短期疗效观察

Short-Term Clinical Outcomes of Immediate Implantation versus Delayed Implantation after Socket Preservation in Maxillary Molar Area for Patients with Severe Chronic Periodontitis

目的:观察慢性重度牙周炎患者行系统性牙周治疗后上颌磨牙区拔牙后即刻种植和位点保存术后延期种植两种种植方式的短期临床疗效。方法:38例慢性重度牙周炎患者导致上颌后牙区牙齿保留无望,经过系统性牙周治疗及复查提示牙周状况良好后行种植治疗,共植入修复体49枚,其中即刻种植组23枚,位点保存术后延期种植组26枚,种植术后3~6个月行修复治疗。观察种植体留存情况及修复后种植体周围组织状况。结果:种植体脱落情况:即刻种植组2枚,延期种植组1枚,存留率分别为91.30%和96.15%。两组种植体种植修复后即刻及6月后复查的PD、BI、BOP(+)相比,差异均无统计学意义(P>0.05);观察期内种植成功的种植体功能良好,种植体周围软组织健康状况良好。结论:慢性重度牙周炎患者经过完善的牙周系统治疗,在牙周状况良好的条件下,上颌后牙区拔牙后即刻种植和位点保存术后延期种植短期内临床效果相当。

Objective：To compare the short-term clinical outcomesof immediate implantationversus delayed implantationin preserved sockets of the maxillary molar areaafter systematic periodontaltreatment in patients with severe chronic periodontitis.Methods：Thirtypatients with severe chronic periodontitis and partially edentulous in the maxillary molar area were screened outfrom January 2013 to 2015in the Department of Periodontology,Stomatologic Hospital College,Anhui Medical University.After the control of periodontal infection,a total of 49 implants were implanted,including 23 immediate implantations and 26 delayed implantations.Implant supported dentures were made after 3-6months.All patients were followed up for 6months after loading.The implant failure and peri-implant tissue conditions were recorded.Results：Two implants failed in the immediate implantation group and one implant failed in the delayed implantation group.The survival rate was 91.30% and 96.15%,respectively.At the delivery of definitive crowns and 6months after loading,all implants received periodontal examination and there was no statistically significant difference,including probe depth（PD）,blooding index（BI）,and blooding of probe（BOP）.During the observation time,the definitive crowns and periodontal tissue of all successful implants were in good function.Conclusion：After comprehensive periodontal treatment andwell-control,the clinical outcome appears to be similar for immediate implantation and delayed implantation in the maxillary molar area for patients with severe chronicperiodontitis.