延期种植中牙槽嵴保存术对不同骨缺损量患者的适用性分析

Analysis of the applicability of alveolar ridge preservation in the treatment of delayed implantation on patients with different amount of bone defect

目的:对比分析延期种植中,牙槽嵴保存术对不同骨缺损量患者的影响。方法:纳入下颌单颗后牙延期种植患者80例,根据其牙槽嵴骨缺损量分组,试验A组均为缺损量≤5mm的患者,共48例,试验B组均为骨缺损量>5mm的患者,共32例。在拔牙后进一步将A、B组随机均分为1组、2组,其中A1、B1组均接受牙槽嵴保存术;A2、B2组未对牙槽窝行特殊处理。拔牙6个月后,患者接受种植体植入,并予持续随访。分别于拔牙后、种植体植入前检测患者牙槽嵴高度及宽度;分别于拔牙前、种植体植入前检测缺牙区邻牙的牙周袋探诊深度(PPD)、牙龈退缩水平(GRL)、临床牙龈附着水平(CAL);分别于种植体植入即刻、1、2、3个月测定种植体稳定系数(ISQ)。结果:所有患者牙槽窝均愈合良好,B2组中3例患者不宜植入种植体,剔除,其他患者植入种植体后未见种植体周围炎或脱落。A1、B1组种植体植入前牙槽嵴高度及宽度减少量均分别少于A2、B2组,同时A1、A2组牙槽嵴高度及宽度减少量均分别少于B1、B2组,差异有统计学意义(P<0.05)。与拔牙前相比,所有患者PPD、CAL均明显下降,GRL均明显上升,差异有统计学意义(P<0.05),但同时点各组对比,组间差异均不显著(P>0.05)。所有患者ISQ均呈先下降后上升趋势(P<0.05),植入种植体后2个月、3个月组间对比,A1、A2组ISQ明显高于B1、B2组,且B1组ISQ明显高于B2组,差异均有统计学意义(P<0.05)。结论:牙槽嵴保存术有助于增加牙槽骨骨量,并为延期种植提供良好条件;对牙槽嵴骨缺损量>5mm的患者,其适用价值更明显。

Objective：To compare and analyze the effect of alveolar ridge preservation in the treatment of de-layed implantation on patients with different amount of bone defect. Methods： 80 cases with single mandibular posterior tooth delayed implant were divided into 2 groups according to the amount of bone defect before tooth extraction. 48 cases whose amount of bone defect≤5mm were included into Group A, while 32 cases whose amount of bone defect＆gt;5mm were included into Group B. After tooth extrac-tion, Group A and B were randomly divided into 2 groups respectively. Group A1 and B1 were treated with alveolar ridge preservation, while Group A2 and B2 did not get special treatment on the alveolar fossa. 6 months after tooth extraction, patients received implants and were followed up continuously. The height and width of alveolar ridge were detected at the timepoint after tooth extraction and before tooth implantation. PPD, GRL and CAL of adjacent teeth in missing area were detected at the timepoint before tooth extraction and before tooth implantation. ISQ of implant were detected immediately, 1 month, 2 months and 3 months after implantation. Results： All alveolar fossa were healed well. 3 cases in Group B2 were not suitable for tooth implantation and were taken out. The other patients had no plant peripheral inflammation or shedding after implantation. The height and width reduction of alveolar ridge in Group A1 and B1 were less than A2 and B2 respectively, and height and width reduction of alveolar ridge in Group A1 and A2 were less than B1 and B2 respectively. The differences were statis-tically significant （P＆lt;0.05）. PPD and CAL of all patients significantly decreased after tooth extraction, while GRL increased significantly. The differences were statistically significant（P＆lt;0.05）. But differences between groups at a same time were not significant （P＆gt;0.05）. ISQ in all patients decreased at beginning and then increased significantly （P＆lt;0.05）. ISQ in Group A1 and A2 were significantly higher than in Group B1 and B2, and ISQ in Group B1 was significantly higher than in group B2 at 2 months and 3 months after implantation. The differences were statistically significant （P＆lt;0.05）. Conclusion： Alveolar ridge preservation is helpful to increase the bone mass, and provide good conditions for delayed im-plantation. The value in patients whose amount of bone defect＆gt;5mm is more obvious.