不同年龄对种植位点骨密度的影响分析

Effects of different ages on bone mineral density at oral implant sites

目的:探讨不同年龄阶段颌骨种植位点骨密度的变化特征,为老年人缺牙区行种植修复提供临床参考。方法:对170例牙列缺损的患者进行CBCT扫描,共有408个可种植位点,利用Simplant软件测量牙缺失位点的骨密度,骨密度值以Hounsfield units(HU)表示。结果:牙缺失位点骨密度平均值为(513.61±189.98)HU,下颌前牙区(710.58±216.97)HU>上颌前牙区(700.50±122.93)HU>下颌后牙区(470.16±161.15)HU>上颌后牙区(452.95±162.57)HU,上下颌前牙区与上下颌后牙区的骨密度有显著性差异;31~50岁(560.28±183.36)HU>18~30岁(557.61±208.13)HU>51~70岁(459.38±170.50)HU,年龄高于50岁的患者骨密度与其他两组相比有显著性差异(P<0.05),并且Ⅳ类骨质比例明显增加。男女性别间的差异无统计学意义(P>0.05)。结论:50岁以上的中、老年人种植位点的骨密度明显降低,医师术前应充分评估这类人缺牙区域的骨密度及全身健康状况,以提高种植体初期稳定性及远期成功率。

Objective:To investigate the bone mineral density(BMD)of mandibular implant sites at different age stages,and to provide clinical reference for implant restoration of missing teeth in the elderly.Methods:170 patients with missing teeth were scanned by CBCT,including a total of 408 implant sites.Bone mineral density in the missing teeth area were measured by using Simplant software and expressed as Hounsfield units(HU).Results:The average bone mineral density of the missing teeth sites was(513.61±189.98)HU,the anterior mandibular area(710.58±216.97)HU>the maxillary anterior area(700.50±122.93)HU>the mandibular posterior area(470.16±161.15)HU>the maxillary posterior area(452.95±162.57)HU.The bone mineral density of the anterior area at the jawbone shows significant difference with that of the posterior area at the jawbone.The age group of 31~50 years(560.28±183.36)HU>the age group of 18~30 years(557.61±208.13)HU>the age group of 51~70 years(459.38±170.50)HU.There was statistical difference between the group of 51~70 years and the other two groups(P<0.05),and the proportion of bone typeⅣwas significant increased in the 51~70 group.There was no significant difference between the male and female genders(P>0.05).Conclusion:Bone mineral density at the implant site was significantly decreased in older adults over 50 years of age.Before surgery,dentists should fully evaluate the bone mineral density and general health status of the missing tooth area in the elderly,so as to improve the initial stability and long-term success rate of implants.