位点保存对牙槽嵴不同骨量缺损延期种植的影响

Effect of alveolar ridge preservation on delayed implantation in patients with different severity of alveolar bone defect

目的探讨不同程度骨缺损的拔牙窝行位点保存后对延期种植的影响。方法选择92例拟拔牙后行种植修复的患者,依据牙槽骨缺损程度分为A组:骨缺损3-5mm,B组:骨缺损大于5mm。A、B组拔牙后再随机均分为试验组和对照组,实验组牙槽窝植入Bio-Oss骨粉并覆盖Bio-Gide胶原膜,对照组牙槽窝为自然愈合。愈合六个月后比较拔牙区牙槽嵴高度及宽度减少量,种植体植入后即刻及骨整合后稳定系数,观察位点保存对牙槽嵴不同骨量缺损延期种植的影响。结果A、B组内试验组牙槽嵴高度及宽度的减少量均少于对照组;A组牙槽嵴高度及宽度的减少量少于B组。除7名患者骨量不足未能植入种植体,共有85枚种植体植入;骨整合后各组种植体稳定系数均有增加,但A组、B组组内比较,A组、B组交叉比较,都无明显差异。结论位点保存在6个月内能有效减少牙槽骨垂直和水平向吸收,且对牙槽骨原始缺损较重的病例效果更明显。

Objective To investigate the effect of alveolar ridge preservation technique on delayed planting in patients with different severity of alveolar bone defect.Methods alveolar bone defect were selected from August 2015 to August 2016.Based on the different severity of alveolar bone defect,the patients were divided into two groups,A(defect between 3~5 mm)and B(defect greater than5 mm).After tooth extraction,patients in group A and group B were randomly subdivided into treatment group and control group,the treatment group received Bio-Oss bone grafting and Bio-Gide biofilm treatment,the control group received natural healing.Record the reduction of height and width of alveolar ridge,the adjacent tooth periodontal index and implant stability coefficient.Results In group A,the reduction of alveolar ridge height and width were less severe in the treatment group than in the control group(t=5.4329,P=0.0000 and t=4.7098,P=0.0000,respectively).Similar results were obtained in group B,where the reduction of alveolar ridge height and width were less in the treatment group than in the control group(t=9.0939,P=0.0000 and t=12.0082,P=0.0000,respectively).The reduction of alveolar ridge height and width in group A were less than those in group B.Significant difference was observed between the two groups(P<0.05).A total of 85 out of 92 implants were planted in patients,the rest seven failed due to insufficient bone mass.In all groups,ISQ increased over time but no significant difference was observed between any groups(P>0.05).Conclusion When Alveolar bone defect is greater than 5 mm,the alveolar ridge preservation technique is more necessary for delayed planting.