3D数字化种植导板牙龈不翻瓣与翻瓣对口腔种植治疗效果的影响

Efficacy of flapless versus open flap implant placement using 3D digital implant guide technique

目的基于锥形束电子计算机断层扫描(CBCT)探讨3D数字化种植导板牙龈不翻瓣与翻瓣对口腔种植治疗效果的影响。方法 2019年1月~2020年1月医院口腔修复科收治入院治疗的72例牙列缺失患者,按照患者意愿和实际情况分为不翻瓣组和翻瓣组,不翻瓣组经CBCT设计制作不翻瓣颌骨模型和种植导板,翻瓣组经CBCT设计制作翻瓣颌骨模型和种植导板。比较两组治疗情况、术后种植体距离偏差值和角度偏差值、种植成功率、口腔种植相关不良事件发生率和手术满意度。结果不翻瓣组手术时间、术后肿痛时间和抗生素使用时间显著短于翻瓣组(P<0.05);翻瓣组颈部、根尖部和深度距离偏差值以及角度偏差值显著小于不翻瓣组(P<0.05);不翻瓣组种植成功率显著高于翻瓣组(P<0.05);不翻瓣组口腔种植相关不良事件发生率显著低于翻瓣组(P<0.05);不翻瓣组手术满意度显著高于翻瓣组(P<0.05)。结论 3D数字化种植导板牙龈不翻瓣技术可显著缩短口腔种植患者手术时间、术后肿痛时间和抗生素使用时间,提高种植成功率,降低口腔种植相关不良事件发生率,并获得较好的手术满意度,3D数字化种植导板牙龈翻瓣技术可有效提高口腔种植的精确度,临床可根据实际情况进行合理选择。

Objective To investigate efficacy of flapless versus open flap implant placement using cone beam computed tomography(CBCT)digital implant guide technique.Methods 72 partially edentulous patients in our hospital from January 2019 to January 2020 were enrolled,and divided into flapless group and flap group according to patients’willingness.Flapless group received tooth implantation on the maxillary models under flapless surgery and dental implant guide designed by CBCT,and flap group received tooth implantation on the maxillary models under flap surgery and dental implant guide designed by CBCT.Then the treatment efficacy,distance deviation and angle deviation,implant success rate,incidence of oral implant related adverse events and surgical satisfaction were compared between groups.Results Flapless group had shorter operation time,milder postoperative swelling and pain and lower consumption of analgesics than those of flap group(P<0.05).The deviation values of implant top,bottom,vertical distance,and angle deviation of flap group were lower than those of flapless group(P<0.05).The success rate of implantation in flapless group was significantly higher than that in flap group(P<0.05);the incidence of oral implant related adverse events in flapless group was significantly lower than that in flap group(P<0.05);the surgical satisfaction in flapless group was significantly higher than that in flap group(P<0.05).Conclusion Tooth implantation on the maxillary models under flapless surgery and dental implant guide designed by CBCT has the advantages of shorter operation time,milder postoperative swelling and pain and lower consumption of analgesics,with high success rate and satisfaction rate,and low adverse reaction rate,while flap surgery and dental implant guide designed by CBCT has higher implantation accuracy rate,so the clinical application can be selected based on patients’condition.