上颌单个前牙即刻与延期微创拔牙修复的效果比较

Comparison of effects immediate versus delayed minimally invasive extraction restoration on single maxillary anterior tooth disease

目的比较上颌单个前牙即刻与延期微创拔牙修复的效果。方法选择2017年1月至2019年1月河南大学第一附属医院诊治的上颌单个前牙患疾无保留价值的患者80例,共80颗上颌中切牙。根据拔牙后修复方法分为即刻修复组(42例)与延期修复组(38例)。观察两组患者修复区周围软组织情况、牙槽骨吸收水平、美学效果评分及并发症发生情况。结果两组患者1年后修复成功率比较差异未见统计学意义(P>0.05)。两组患者修复后第12个月的改良龈沟出血指数(mSBI)高于修复后第1、3、6个月,且第1个月高于第3、6个月,低于第12个月(P<0.05);两组患者第3、6、12个月的mSBI比较差异未见统计学意义(P>0.05),第1个月时即刻修复组mSBI高于延期修复组(P<0.05)。即刻修复组第1、3、6、12个月时牙周探诊深度(PD)比较差异未见统计学意义(P>0.05);延期修复组第1个月时PD高于第3、6、12个月(P<0.05);即刻修复组第1、3、6、12个月的PD均低于延期修复组患者(P均<0.05)。两组患者第12个月时牙槽骨吸收水平比较差异未见统计学意义(P>0.05);即刻修复组第6个月时牙槽骨吸收水平低于延期修复组(P<0.05);两组患者第6个月时牙槽骨吸收水平均高于第12个月(P均<0.05)。两组患者各时间段与各级美学效果评分比较差异均有统计学意义(P均<0.05)。两组患者并发症发生率比较差异未见统计学意义(P>0.05)。结论相较于延期修复,微创拔牙后即刻修复的牙槽骨吸收水平较少,修复结束后并发症较少,美学效果评分更佳。

Objective To compare the effects of immediate and delayed minimally invasive extraction restoration on single maxillary anterior tooth disease.Methods Eighty patients with single maxillary anterior tooth which had no retention value treated in the First Affiliated Hospital of Henan University from January 2017 to January 2019 were selected,including a total of 80 maxillary central incisors.According to restoration methods after tooth extraction,patients were divided into immediate restoration group(n=42)and delayed restoration group(n=38).Then the soft tissues around the restoration area,alveolar bone resorption level,aesthetic effect score and complications of the two groups were observed.Results There was no significant difference in success rate between the two groups 1 year after restoration(P>0.05).The modified sulcus bleeding index(mSBI)of two groups at the 12th month after restoration was higher than that at the 1st,3rd and 6th months after restoration,moreover,the levels at the 1st month after restoration was higher than that at the 3rd and 6th months after restoration(P<0.05).The mSBI at the 3rd,6th and 12th months after restoration had no significant difference between the two groups(P>0.05).The mSBI at 1st month after restoration was higher in the immediate restoration group than that in the delayed restoration group(P<0.05).In the immediate restoration group,there was no significant difference in probing depth(PD)index at the 1st,3rd,6th and 12th months after restoration(P>0.05).In the immediate restoration group,PD index at the 1st month after restoration was higher than that at the 3rd,6th and 12th months after restoration(P<0.05).PD index of the immediate restoration group at the 1st,3rd,6th and 12th months after restoration were lower than those of the delayed restoration group(P<0.05).The alveolar bone resorption level had no significant difference between groups at the 12th month after restoration(P>0.05).The alveolar bone resorption level of the immediate restoration group was lower than that of the delayed restoration group at the 6th month after restoration(P<0.05).The alveolar bone resorption level in both groups at the 6th month after restoration was significantly higher than that at the 12th month after restoration(P<0.05).The aesthetic effect scores at different time periods and scores of aesthetic effects had significant difference between the two groups(P<0.05).There was no significant difference in the incidence of complications between two groups(P>0.05).Conclusions The advantages of immediate restoration over delayed restoration after minimally invasive tooth extraction include lower alveolar bone absorption level,fewer complications,and better aesthetic effects.