微创环切技术与传统翻瓣种植术对于牙列缺损患者口腔种植后牙槽嵴顶骨吸收的影响

Effect of minimally invasive circumcision and traditional flap implantation on alveolar ridge parietal bone resorption in patients with dental defect

目的对比分析微创环切技术与传统翻瓣种植术对于牙列缺损患者口腔种植后牙槽嵴顶骨吸收的影响。方法选择2014年6月至2015年12月在解放军第三二三医院采用微创环切术植入58颗种植体作为研究组,其中男性25例(植入种植体27颗),女性28例(植入种植体31颗);年龄32~55岁,平均年龄41.58岁;牙缺损时间为6~23个月;牙槽嵴宽度>10 mm。选择同期行传统翻瓣种植术的50颗种植体作为对照组,其中男性20例(植入种植体21颗),女性24例(植入种植体29颗);年龄30~56岁,平均年龄42.14岁;牙缺损时间为6~24个月;牙槽嵴宽度>10 mm。两组患者术后随访1年,观察两组术后并发症及成功率,对比两组种植体稳定性及牙槽嵴顶骨吸收量。结果研究组中1例患者术后出现感染、肿胀情况,种植成功率为98.28%;对照组患者中术后出现感染、肿胀情况3例,种植体松动2例,术后6个月种植体周围有明显骨吸收2例,种植成功率为86.00%;两组比较,差异具有统计学意义(P<0.05)。术后第1天,研究组患者视觉模拟量表(VAS)评分为(2.58±1.16)分,对照组为(3.84±1.35)分,差异有统计学意义(P<0.05);术后6个月,两组牙槽嵴顶骨吸收量比较,研究组明显小于对照组[(0.24±0.06)mm vs(0.95±0.09)mm],差异有统计学意义(P<0.05);种植体植入3个月后,研究组种植体稳定系数略高于对照组[(84.21±2.24)vs(82.36±2.61)],两组比较,差异无统计学意义(P>0.05)。结论对于骨量留存好牙缺失患者采用微创环切种植技术进行牙种植,术后不良情况发生较少,疼痛较轻,术后种植体稳定性较好,牙槽嵴顶骨吸收量较小,种植成功率高,值得临床推广使用。

Objective To compare and analyze the effect of minimally invasive circumcision and traditional flap implantation on the resorption of alveolar ridge parietal bone in patients with dental defect. Methods From June 2014 to December 2015, 58 minimally invasive circumcision implants patients were enrolled as study group, which included 25 males（27 implants） and 28 females（31 implants）, aged 32 - 55 years old with mean age of 41.58 years old, the dental defect time was 6 - 23 months and alveolar ridge width 〉 10 mm. At the same time, 50 conventional flap implants were selected as control group, which included 20 males（21 implants） and 24 females（29 implants）, aged 30 - 56 years old with mean age of 42.14 years old, the dental defect time was 6 - 24 months and alveolar ridge width 〉 10 ram. After operation, 1-year follow-up of postoperative complication and success rate were observed and implant stability and crestal resorption were compared between 2 groups. Results In study group, the implant success rate was 98.28 %, 1 patient occurred postoperative infection and swelling. In control group, the im- plant success rate was 86.00 %, 3 cases with postoperative infection, swelling, 2 cases with implants loosening and 2 cases showed obvious bone resorption after 6-month. There were significant differences between 2 groups（P 〈 0.05）. One day post oper- ation, the visual analogue scale（VAS） score of study group was （2.58 ± 1.16） significantly lower than that of control group （3.84 ± 1.35）（P 〈 0.05）. After 6-month, the alveolar ridge bone absorption of study group was significantly less than that of control group [（0.24 ± 0.06） mm vs （0.95 ± 0.09） ram] （P 〈 0.05）. Three-month after implantation, the implants stability coefficient of study group was slightly higher than that of control group[（84.21 ± 2.24） vs （82.36 ± 2.61）], however, there was no statistically signifi- cant difference between 2 groups（P 〉 0.05）. Conclusion It is demonstrated that the minimally invasive circumferential planting techniques of dental implants is suitable for dental defect patients with bone retained, it showed less postoperative adverse events, pain and alveolar ridge bone resorption, higher implants stability and success rate, so it is worth popularizing in clinic.