牙种植体乳头水平的影响因素分析

Analysis of Influencing Factors on the Level of Dental Implant Papilla

目的:分析牙种植体乳头水平的影响因素。方法:选取2016年1月-2018年1月笔者医院进行牙种植体修复治疗的51例患者为研究对象。对比牙种植体乳头退缩和乳头充盈患者的一般资料,应用Kaplan-Meier法进行牙种植体乳头退缩事件的生存分析,应用单因素和多因素Logistic回归模型分析牙种植体乳头水平的影响因素。结果:Kaplan-Meier法进行牙种植体乳头退缩事件发生风险分析,截止至牙种植修复术后24个月,牙种植体乳头退缩事件的发生率为45.10%;两组患者的年龄、吸烟、牙周表型、手术方案、基础乳头水平、基线角化组织高度、唇侧骨板厚度比较,差异具有统计学意义(P<0.05);单因素Logistic回归分析显示:年龄(OR=1.147,P=0.048)、吸烟(OR=3.778,P=0.029)、牙周表型(薄型)(OR=4.667,P=0.012)、手术方式(延期种植)(OR=4.114,P=0.019)、基础乳头水平(不完全填充)(OR=7.083,P=0.002)是影响牙种植体乳头水平危险因素,基线角化组织高度(OR=0.456,P=0.017)是影响牙种植体乳头水平的保护因素;多因素Logistic回归分析显示:手术方式(延期种植)(OR=35.808,P=0.008)、基础乳头水平(不完全填充)(OR=9.009,P=0.020)是影响牙种植体乳头水平的独立危险因素,基线角化组织高度(OR=0.422,P=0.048)是影响牙种植体乳头水平的保护因素。结论:手术方案(延期种植)、基础乳头水平(不完全填充)是影响牙种植体乳头水平的独立危险因素,而基线角化组织高度是影响牙种植体乳头水平的保护因素,因此,种植体周围软组织的稳定性取决于牙周表型、乳头高度和角化组织高度。

Objective To analyze the influencing factors of the papilla level of dental implants.Methods A total of 51 patients who underwent dental implant restoration treatment in our hospital from January 2016 to January 2018 were selected as the research object.The general data of patients with dental implant papilla retraction and papilla filling were compared.Kaplan-Meier method was used for survival analysis of dental implant papilla retraction events.Univariate and Multivariate Logistic regression models were used to analyze the influencing factors of dental implant papilla level.Results The Kaplan-Meier method was used to analyze the risk of dental implant papilla retraction events.As of 24 months after dental implant restoration,the incidence of dental implant papilla retraction events was 45.10%.The differences in age,smoking,periodontal phenotype,surgical plan,basic papilla level,baseline keratinized tissue height,and labial bone plate thickness between the two groups were statistically significant(P<0.05).Univariate logistic regression analysis showed that age(OR=1.147,P=0.048),smoking(OR=3.778,P=0.029),periodontal phenotype(thin)(OR=4.667,P=0.012),surgical method(delayed implant)(OR=4.114,P=0.019),basal papilla level(incomplete filling)(OR=7.083,P=0.002)were a risk factor affecting the level of dental implant papilla.baseline keratinized tissue height(OR=0.456,P=0.017)was a protective factor that affects the level of dental implant papilla.Multivariate logistic regression analysis showed that surgical method(delayed implantation)(OR=35.808,P=0.008),basic papilla level(incomplete filling)(OR=9.009,P=0.020)were independent risks affecting the level of dental implant papilla factors,baseline keratinized tissue height(OR=0.422,P=0.048)was a protective factor that affects the level of dental implant papilla.Conclusion Surgical plan(delayed implantation)and basic papilla level(incomplete filling)are independent risk factors that affect the level of dental implant papilla,while baseline keratinized tissue height is a protective factor that affects the level of dental implant papilla.Therefore,the stability of the soft tissue around the implant depends on the periodontal phenotype,papilla height and keratinized tissue height.