2种即刻种植方法在下颌磨牙区的精度比较

Accuracy of implantation between two immediate implantation methods in mandibular molars

目的:比较改良与传统2种即刻种植方法在下颌磨牙种植中的精准度。方法 :选择下颌磨牙区即刻种植患者24例,共计24个种植位点。术前拍摄锥形束CT(CBCT),用数字化软件Simplant 18.0设计种植体理想的三维位置。试验组以剩余天然牙体组织为参照,优先预备种植窝洞,微创拔除患牙后再将种植体植入;对照组按照传统流程,依次微创拔牙、备洞、植入种植体。术后均行CBCT检查,并用Simplant 18.0测量术前、术后三维位置的误差。采用SPSS 17.0软件包进行统计学分析。结果:24例患者均顺利完成手术,5~6个月后行冠部修复,种植体保留率为100%。试验组与对照组角度偏差分别为(4.492±0.912)°和(7.255±1.307)°,颈部水平偏差分别为(0.379±0.083) mm和(1.229±0.270) mm,测量根端水平偏差分别为(1.263±0.267) mm和(2.183±0.264) mm;计算根端水平偏差分别为(1.324±0.203) mm和(2.709±0.383) mm,深度偏差分别为(0.663±0.123) mm和(1.533±0.155) mm;所有项目的差异值均有统计学意义(P<0.01)。结论:改良即刻种植相比传统即刻种植,可提高下颌磨牙区种植体的精准度。

PURPOSE: To compare the accuracy of implant placement between modified and traditional immediate implant placement in mandibular molar regions. METHODS: Twenty-four patients were selected for immediate implantation in the molar area including 24 implantation sites. Preoperative cone-beam CT(CBCT) was conducted and then digital software Simplant 18.0 was used to design the ideal three-dimensional position of the implants. In the experimental group, the implant socket was prepared first according to reference of the remaining natural teeth, then the implant was implanted after minimally invasive extraction. Twelve patients in the control group underwent immediate implantation by traditional immediate implant procedures. Minimally invasive extraction, then socket preparation, and final implanting were performed. All patients underwent CBCT after surgery. Implant sites designed prior to surgery and actual implant sites differences between modified and traditional immediate implant placement were measured by Simplant 18.0 and compared with SPSS 17.0 software package. RESULTS: In the experimental group and control group, the measured average deviation were as follows, the angle was(4.492±0.912)° and(7.255±1.307)°, respectively;The horizontal error of the implant shoulder was(0.379±0.083) mm and(1.229±0.270) mm, respectively;The measuring horizontal error of the implant apex was(1.263±0.267) mm and(2.183±0.264) mm, respectively;The calculative horizontal error of the implant apex was(1.324±0.203) mm and(2.709±0.383) mm, respectively;Depth error of the implant apex was(0.663±0.123) mm and(1.533±0.155)mm, respectively, which were significantly lower than those of the control group. CONCLUSIONS: Compared with the traditional method, modified immediate implantation can improve the accuracy of implantation in mandibular molars.