一字形切口的种植二期手术牙龈美学效果临床研究

A Study on the Aesthetic Effect of the Second-stage Surgical Gingiva in Line-styled Surgical Incision

目的探讨上颌前牙美学区单牙种植义齿修复患者,用一字形切口、环切法和翻瓣法三种种植二期软组织手术方法获得的临床美学效果研究。方法随机选择96例上颌前牙美学区单牙种植修复患者,将其按种植二期手术方法的不同随机分为三组,每组32颗种植体。A组采用一字形切口,B组采用环切法,C组采用传统翻瓣法(对照组)。观察这三种种植二期软组织手术方法对前牙美学区牙列缺损种植修复的临床疗效及美学意义。结果 3组有96颗种植体均获得良好的骨结合;当24个月时,一字形切口2~3级占87.5%,环切术占78.1%,翻瓣术占59.4%,P<0.05,差异有统计学意义。3种术法DPES见表2。结果显示修复体的唇侧龈缘与邻牙唇侧龈缘位置关系<2 mm时,一字形占93.8%,环切术占75.0%,翻瓣术占65.6%。P<0.05,三者间有统计学差异。3种术法改良龈沟出血指数、菌斑指数都<=1,无统计学差异。结论前牙美学区单颗牙缺损种植二期修复时,与传统翻瓣术及环切术相比,采用一字形切口,软组织可以获得较好的临床疗效及美学效果。

Objective To explore the clinical aesthetic effect of one-piece incision, ring cutting method and flap method in the implantation of the single-tooth implant denture in the maxillary anterior teeth. Method 96 patients with maxillary anterior teeth were randomly selected and divided into three groups（32 implants） according to the different surgical method. Methods. Group A was treated with the line-styled surgical incision. Group B were treated with ring cutting method, group C were given the traditional flap method. To observe the clinical efficacy and aesthetic significance of three implantation soft tissue surgical methods on the restoration of dentition defect in the anterior teeth. Result 96 implants of 3 groups were all obtained good Osseo integration. After 24 months, 2-3 level of the line-styled surgical incision was accounted for 87.5%, that of ring cutting method was accounted for 78.1% and that of periodontal flab surgery was accounted for 59.4%, which were all P〈0.05, with statistical differences. The DPES of 3 methods showed that the position of the gingival margin of the prosthesis and the gingival margin of the adjacent lips were 〈2 mm. The line-styled surgical incision was accounted for 93.8%, SCF was accounted for 75.0% and periodontal flab surgery was accounted for 65.6%, there were statistical differences among 3 methods（P〈0.05）. All 3 surgical methods could improve Sulcus bleeding index（SBI）, and their Plaque indexes（PI）were 〈=1, and there was no statistical difference. Conclusion When single tooth implant in the maxillary anterior teeth area is performed,adopting the line-styled surgical incision of two-stage operation of dental implants can obtain better clinical therapeutic and aesthetic effects than the traditional periodontal flab surgery.