基于CBCT的上颌前牙区GBR骨增量早期效果及并发症的研究

The study of the early effect and complications of GBR bone augmentation in maxillary anteriorarea based on CBCT

目的基于锥形束CT(CBCT)对上颌前牙区种植手术同期行引导骨再生术(GBR),分析唇侧骨增量的早期效果,并探讨GBR并发症发生的处理及预后.方法选取2016年1月至2018年12月因外伤、龋坏导致上颌前牙区牙齿缺失,选择种植修复的患者15例,共20颗种植体,于种植手术同期GBR术后即刻(T1)、术后6个月~2年(T2)进行CBCT检查,复查种植体唇侧成骨情况,测量种植体肩台处(H1),种植体肩台下2 mm(H2),种植体肩台下4 mm(H3),种植体肩台下6 mm(H4)水平向唇侧骨宽度.结果20颗种植体发生种植体失败1颗,种植体存活率为95%,发生GBR并发症植体2颗,并发症发生率10%,经过相关治疗后好转;H1、H2、H3、H4四组在T1、T2时间段内唇侧骨宽度比较差异有统计学意义(P<0.05).H1、H2、H3、H4四组GBR骨吸收率分别为31.58%,22.54%,19.85%,23.10%.结论在种植体植入同期GBR术,虽然存在一定程度的骨粉吸收,但上颌前牙区唇侧骨板在短期内仍然可以获得较为稳定的骨增量效果,当并发症发生时通过有效治疗措施可以获得良好的外观和功能效果.

Objective To analyze the early effects of the labial bone augmentation in maxillary anterior dental implant surgery with GBR based on CBCT,and to explore the management of GBR complications and its prognosis.Methods A random selection of 2016~2018 in the Department of Stomatology of Hangzhou Hospital of Traditional Chinese Medicine caused loss of teeth in the maxillary anterior area due to trauma and caries.15 patients were selected for implant restoration,a total of 20 implants.CBCT examination was performed immediately(T1)and 6 months to 2 years(T2)after implant surgery.Review the labial osteogenesis of the implant,the bone width horizontal to the labial side was measured of the implant shoulder stand(H1),2 mm(H2),4 mm(H3)and 6 mm(H4)under the shoulder of the implant.Results 1 implant failed in 20 implants,the survival rate of implants was 95%and 2 implants with GBR complications occurred,and the complication rate was 10%,which getting better after related treatment.The statistical results of the four sets of data in the two time periods were statistically significant,and the absorption rates were 31.58%,22.54%,19.85%and 23.10%,respectively.Conclusion During the same period of GBR surgery with implant surgery,although there is a certain degree of GBR bone absorption,the labial bone plate in the maxillary anterior region can obtain a relatively stable bone augmentation in the short term,and when complications occur,good aesthetics and functional effects can be obtained through treatment measures.