不翻瓣微创法对口腔种植手术效果及美观度的影响

The effects of minimally invasive flapless technique on the surgical effects and aesthetics of oral implant operation

目的探讨不翻瓣微创法对口腔种植手术效果及美观度的影响。方法将2018年1月至2019年1月行口腔种植手术的104例患者随机分为2组,对照组52例使用常规翻瓣种植治疗,观察组52例使用不翻瓣微创法治疗,对比2组患者的种植成功率、各项种植治疗指标、红色美学指数(PES)及视觉模拟评分(VAS)变化、嵴顶吸收以及龈沟深度、牙龈乳头高度指数(PIS)、修复体与邻牙唇侧龈缘位置关系(DPES指数)。结果观察组种植成功率明显高于对照组,而感染、出血、肿胀、种植体松动等不良反应发生率明显低于对照组,差异有统计学意义(P<0.05);观察组种植时间、术后疼痛时间、术后肿胀时间均明显短于对照组,差异有统计学意义(P<0.05);观察组术后PES评分明显高于对照组,而VAS疼痛评分明显低于对照组,差异有统计学意义(P<0.05);术后12个月复查,观察组的嵴顶吸收明显少于对照组,差异有统计学意义(P<0.05),但2组在龈沟深度上无明显差异(P>0.05);观察组术后12个月的Ⅱ~Ⅲ级PIS明显高于对照组,差异有统计学意义(P<0.05);观察组术后12个月的修复体与邻牙唇侧龈缘在高度无差异、差异<2 mm的比例明显高于对照组,而差异>2 mm的比例明显明显低于对照组,差异有统计学意义(P<0.05)。结论不翻瓣微创法对口腔种植手术效果显著,手术时间短,术后疼痛及水肿轻,美观效果好,安全性高,能够获得理想的修复效果,具有积极的临床意义。

Objective To investigate the effects of minimally invasive flapless technique on the surgical effects and aesthetics of oral implant operation.Methods A total of 104 patients who underwent oral implant surgery in our hospital from January 2018 to January 2019 were randomly divided into control group and observation group,with 52 patients in each group.The patients in control group were treated by conventional flap implantation,however,the patients in observation group were treated by minimally invasive flapless technique.The implant success rate,various indicators of implantation,changes in pink esthetic score(PES)and visual analogue score(VAS),crest absorption and gingival sulcus depth,papilla index score(PIS),and the positional relationship between the gingival margin of prosthesis and the gingival margin of adjacent lips(DPES index)were observed and compared between the two groups.Results The implant success rate in observation group was significantly higher than that in control group,while the incidence of adverse reactions including infection,bleeding,swelling,and implant loosening was significantly lower than that in control group(P<0.05).The duration of implantation and postoperative pain as well as postoperative swelling time in observation group were significantly shorter than those in control group(P<0.05).The postoperative PES scores in observation group were significantly higher than those in control group,however,the VAS pain scores were significantly lower than those in control group(P<0.05).At 12 months after surgery,the crest absorption in observation group was significantly less than that in control group(P<0.05),however,there was no significant difference in the depth of the gingival sulcus between the two groups(P>0.05).The classⅡ~ⅢPIS in observation group at 12 months after surgery was significantly higher than that in control group(P<0.05).There was no difference in height between between the gingival margin of prosthesis and the gingival margin of adjacent lips at 12 months after surgery,but the proportion of the difference<2mm in observation group was significantly larger than that in control group,while the proportion of the difference>2mm was significantly less than that in control group(P<0.05).Conclusion The minimally invasive flapless technique is effective in oral implant surgery,with shorter duration of operation,milder postoperative pain and edema,and better aesthetics and safety,which has ideal repair effects and positive clinical significance.