前牙牙根屏障即刻种植术(SST)的临床和美学效果

Clinical and aesthetic effects of socket-shield technique(SST) for the root barrier in anterior teeth

目的探讨前牙牙根屏障即刻种植术(SST)的临床和美学效果。方法前瞻性选取2016年3月至2018年3月于浙江绿城心血管病医院接受前牙置换治疗的63例患者作为研究对象,随机分为SST组(n=31)和对照组(n=32);SST组患者行SST治疗,对照组行常规即刻种植术治疗,通过软组织萎缩程度和粉色审美评分(PESs)评价比较两组患者临床效果及美学效果,包括改良龈沟出血指数(mSBI)、牙槽骨高度、植入物稳定性商(ISQ)、颊板宽度(BPW)、颊板高度(BPH)及PESs评分,并比较两组植入结果及并发症发生情况。结果两组患者均植入成功,随访24个月,截至末次随访时间2020年3月,共有3例患者因不同原因失访,其中SST组1例,对照组2例,剩余60例患者均完成随访;术后12个月、24个月,两组ISQ比较,差异无统计学意义(P>0.05);术后12个月、24个月,SST组mSBI低于对照组,牙槽骨高度高于对照组,BPW、BPH高于对照组,PESs评分高于对照组,差异有统计学意义(P<0.05);两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论SST可通过维持牙槽骨容积和种植体周围组织,改善牙槽骨功能和美学效果,在种植美学区可作为有效的治疗方法。

Objective To investigate the clinical and aesthetic effects of the socket-shield technique(SST)for the root barrier in anterior teeth.Methods A total of 63 patients who received anterior teeth replacement therapy in Zhejiang Greentown Cardiovascular Hospital from March 2016 to March 2018 were prospectively selected as the research subjects.They were randomly divided into SST group(n=31)and control group(n=32).Patients in the SST group were given SST treatment,and the control group was given conventional immediate implantation.The clinical and aesthetic effects were evaluated and compared between the two groups by the degree of soft tissue atrophy and the pink aesthetic score(PESs),including modified sulcus bleeding index(mSBI),alveolar bone height,implant stability quotient(ISQ),buccal plate width(BPW),buccal plate height(BPH),and PESs score.And the results of implantation and complications were compared between the two groups.Results Both groups of patients were successfully implanted.There were 24 months of follow-up visit as of the last follow-up time in March 2020.A total of 3 patients were lost for different reasons.Among them,there was 1 case in the SST group,2 cases in the control group,and the remaining 60 cases were completed follow-up.There was no significant difference between ISQ groups at 12 months and 24 months after operation(P>0.05);the mSBI in the SST group was lower than that in the control group at 12 and 24 months after surgery.The height of alveolar bone in the SST group was higher than that in the control group,the BPW and BPH in the SST group were higher than those in the control group,and the PESs score in the SST group was higher than that in the control group.The differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence rate of postoperative complications between the groups(P>0.05).Conclusion SST can improve the function and aesthetic effect of alveolar bone by maintaining the volume of the alveolar bone and the tissue around the implant.It can be used as an effective treatment method in the field of aesthetic implantation.