上颌前牙区2种即刻种植术对牙槽骨长度、软硬组织的影响及安全性分析

The effect and safety of two techniques of immediate implants on alveolar bone length,soft and hard tissue in the anterior maxillary zone

目的 :探讨上颌前牙区2种即刻种植术对牙槽骨长度、软硬组织的影响及手术的安全性。方法 :选取2014年8月—2015年8月在我院接受上颌前牙区即刻种植术的患者160例,随机分为翻瓣组(80例)和不翻瓣组(80例),分别运用翻瓣和不翻瓣即刻种植义齿修复,随访1年,观察2组牙槽骨长度、软硬组织变化及手术并发症。采用SPSS17.0软件包对数据进行统计学分析。结果 :翻瓣组种植体成功63例,不翻瓣组为78例,成功率分别为78.75%和97.5%,差异具有显著性(P<0.05)。2组患者均出现疼痛、出血、肿胀等并发症,翻瓣组分别为23.75%、16.25%、20%,总发生率为60%;不翻瓣组分别为11.25%、6.25%、8.75%,总发生率为26.25%,2组差异显著(P<0.05)。治疗后2组患者龈沟深度差异无显著性(P>0.05);牙槽骨长度和嵴顶吸收均较种植前下降,且2组比较差异显著(P<0.05)。结论:不翻瓣即刻种植在降低牙槽骨长度和手术并发症,以及改善软、硬组织等方面均优于翻瓣组,具有良好的临床效果及安全性。

PURPOSE： To investigate the effect and safety of two techniques of immediate implants on the length of alveolar bone as well as the soft and hard tissue in the anterior maxillary zone. METHODS： One hundred and sixty cases of immediate implants in anterior maxillary zone were collected from August 2014 to August 2015 in our hospital. They were randomly and equally divided into flap group （80 cases） and flapless group （80 cases）. The former received flap immediate implant while the later received flapless therapy. A 1-year follow-up, comparison on alveolar bone length, soft tissue and complications was carried out and the results were recorded. The data were analyzed with SPSS 17.0 software package. RESULTS： The number of surviving implants with flap was 63 and the survival rate was 97.5%, while the number of the surviving implants in the flapless group was 63 with survival rate being 78.75% （P〈0.05）. Patients in both groups had pain, bleeding, edema and other complications. The incidence rate of complications of flapless group was 11.25%, 6.25%, 8.75% respectively and the total rate was 26.25% while that of the flap group was 23.75%, 16.25%, 20%, respectively, and the total rate was 60% （P〈0.05） .The depth of gingival sulcus between the two groups had no significant difference after treatment （P〉0.05）. The alveolar bone crest absorption and length decreased after implantation, meanwhile, there was also significant difference between the two groups after implantation （P〈0.05）. CONCLUSIONS： Immediate dental implantation without flap can reduce the length of the alveolar bone and operative complications and improve the contour and physiological condition of soft and hard tissue more than that with flap.