上前牙外伤脱落即刻种植美学修复设计的研究

Study on the design of immediate implant and delayed implant aesthetic restoration in loss of upper anterior teeth caused by trauma

目的探讨研究上前牙外伤脱落即刻种植与延期种植美学修复的应用效果。方法对我院收治的89例单颗上前牙外伤脱落患者临床资料行回顾性分析,其中给予即刻种植美学修复治疗的共47例患者,将其记为即刻组,剩余给予延期种植美学修复治疗的共42例患者,将其记为延期组。比较2组患者种植前后CBCT检查相关指标变化,观察2组成功率、牙槽骨垂直向吸收及不同时刻PES评分,并对比2组患者对色泽、咀嚼功能、附着高度和整体美观的主观满意度。结果种植后2组骨长轴角度显著降低(P<0.05),骨高度显著升高(P<0.05),即刻组显著优于延期组(P<0.05);即刻组成功率为100.00%,远高于延期组的88.10%(P<0.05);即刻组牙槽骨垂直方向吸收明显低于延期组(P<0.05);2组PES评分时间、组间、交互作用均存在显著差异(P<0.05),且2组种植体3个月后、随访结束PES评分均较种植体完成后即刻显著升高(P<0.05),其中即刻组显著高于延期组(P<0.05);即刻组咀嚼功能、附着高度和整体美观满意度评分均显著高于延期组(P<0.05)。结论对上前牙外伤脱落患者行即刻种植美学修复不仅能够提高成功率,还可减少牙槽骨垂直方向吸收,改善软组织美学效果和主观满意度。

Objective To discuss the application effect of immediate implant and delayed implant aesthetic restoration in patients who lost upper anterior teeth caused by trauma. Methods The clinical data of eighty-nine eases of patients with one-loss of upper anterior teeth caused by trauma treated in our hospital were retrospectively analyzed, among which there were forty-seven eases treated with immediate implant aesthetic restoration as the immediate group, and the others were treated with aesthetic restoration of delayed planting as the delayed group. The related indicater changes which were checked by CBCT were compared in the two groups, and successful rates, vertical absorption of alveolar bone and PES scores at different moments in the two groups were observed, and subjective satisfaction to color, chewing function, attached height and overall appearance were compared between the two groups. Results Angle of bone major axis significantly reduced after implant in the two groups（P〈0.05）, and bone height significantly increased（P〈0.05）, which of the immediate group were significantly better than those of the delayed group （P〈0.05）. The successful rate in the immediate group was 100.00%, which was far higher than that of 88.10% in the delayed group （P〈0.05）. The vertical absorption of alveolar bone in the immediate group was obviously less than that in the delayed group （P〈O.05）. There were significant differences in the time, groups, and interaction of PEM scores between the two groups （P〈0.05）. The PES scores in the two groups after 3 months of plant completion and at the end of following-up significantly increased （P〈0.05）, which in the immediate group were significantly higher than those in the delayed group （P〈0.05）. The scores of subjective satisfaction to chewing function, attached height and overall appearance in the im- mediate group were significantly higher than those in the delayed group （P〈0.05）. Conclusion The immediate implant aesthetic restoration in loss of upper anterior teeth caused by trauma can not only increase the successful rate, but also reduce the vertical absorption of alveolar bone and improve the aesthetic effect of soft tissues and subjective satisfaction.