短种植体在磨牙区骨量不足种植位点的应用

Short implants clinical application in molar area with insufficient bone volume

目的观察分析短种植体后牙区骨量不足种植体位点的应用,为高冠根比的种植牙模式的临床应用提供参考。方法筛选种植体长度不大于8mm的种植牙病例,测量对比种植体植入后不同时期颈部位于骨下的高度,对比观察不同时间点种植体颈部骨吸收情况,测量计算人工牙修复后的冠根比,对测量数据进行均数,描述性以及配对T检验等统计学分析。结果本研究收集了158例患者,平均年龄46.6±13.5岁,共植入251颗短种植体,在21.2±0.5个月的随访期内未见失败病例的发生,手术当日种植体植入骨下1.85±0.96mm,经过4-6个月的骨愈合期,种植体颈部的骨高度为1.10±1.00mm,人工牙负重后半年,种植体颈部高度下降至0.78±0.93mm。冠根比平均值为(1.35±0.26):1。采用配对t检验两两比较各个时期种植体颈部骨高度的变化,I期种植体植入术后和II期手术前相比种植体颈部骨骨高度相对差异平均数为0.76±0.98mm,t=6.0,P=0<0.005,组间无显著统计学差异;II期手术前和负载后半年相比,种植体颈部骨高度相对差值为0.32±0.88mm,t=2.77,P=0.007>0.005,两组间差异有统计学意义;比较I期术后和修复体负重后6个月种植体颈部骨高度相对差值为1.07±0.,92,t=9.05,P=0<0.005,两组间无显著统计学差异。结论短种植体在观察期内种植成功率可靠,冠根比增大并未影响种植体成功率,短种植体可以有效应对种植位点骨量不足方法。修复体负重后种植体颈部会有骨高度有显著变化,可促进种植体颈部骨改建。

Objective To observe and analyze the implantation of short implants in the implant site with insufficient of bone volume,in order to provide reference for the clinical implant of short implants.Methods Cases with Short implants that no more than 8mm in length have been selected. The bone resorption around implant neck were measured and compared at different stage in the implantation process. The crown-root ratio after dental prosthesis was measured and calculated. Mean,descriptive and paired T test were used to analyze the measured data. Results A total of 251 short implants were selected that implanted in 158 patients with an average age of 46.6±13.5 years old. We haven’t observed any failure case during the follow-up period of 21.2±0.5months. On the day of operation, the implant was 1.85±0.96mm underneath the alvelor. After 4-6 months of osseointegration, the bone height above implant neck was 1.10±1.00mm,. Six months after loading, the bone height around implant neck decreased to 0.78±0.93mm. Paired T test was used to compare the changes of implant neck bone height in each period. The bone level of relative difference average was 0.76±0.98mm, T=6.0, P=0<0.005 between the period of the two stages of operation. There was no statistical difference between two groups. However, significance statistical difference was observed between the second stage of operation and half year after artificial tooth loading. The Relative difference average height of implant neck bone was 0.32±0.88mm, T=2.77,P=0.007>0.005. There was also no significant difference between the groups that the first stage of operation and half a year after restoration, the relative difference average was 1.07±0.,92,T=9.05,P=0<0.005.Conclusion The success rate of short implant is reliable at the implant site with insufficient bone mass. The implant neck height will change significantly after the artificial teeth loaded. Appropriate occlusal pressure can stimulate the implant neck osteogenesis.