两种不同固定方式对后牙单冠种植义齿修复效果及龈下菌群分布的影响

Influence of Two Different Fixation Methods on the Restoration Effect of Posterior Single Crown Implant Denture and the Distribution of Subgingival Flora

目的:探讨螺丝固定与粘接固定对后牙单冠种植义齿修复效果及齿龈下菌群分布的影响。方法:选取2016年7月-2020年2月笔者医院拟行后牙单冠种植义齿修复的76例患者为研究对象,以随机数字表法分为研究组和对照组,每组38例。对照组采用螺丝固定修复,研究组给予粘接固定修复,修复后随访12个月。对比两组种植区骨吸收量及牙周健康情况,分析两组种植体龈下菌群分布及咀嚼功能,统计两组种植义齿的稳定性及骨密度情况。结果:两组修复后3个月、12个月的骨吸收量对比,差异均无统计学意义(P>0.05)。两组修复后3个月、12个月的龈沟出血指数(Sulcus bleeding index,SBI)、菌斑指数(Plaque index,PLI)、探诊深度(Probing depth,PD)对比差异均无统计学意义(P>0.05)。两组修复后12个月的产黑色素菌、伴放线放线杆菌数量对比差异均无统计学意义(P>0.05),研究组修复后12个月的厌氧菌、具核梭杆菌数量均高于对照组,差异有统计学意义(P<0.05)。两组修复后3个月、12个月,静息时、最大力咬合时咬肌肌电活动对比差异均无统计学意义(P>0.05)。两组修复后12个月的种植义齿稳定系数值、牙槽骨骨密度对比差异均无统计学意义(P>0.05)。结论:螺丝固定与粘接固定均是后牙单冠种植义齿修复的有效方法,两种固定方式观察期效果相近,但粘接固定修复可能造成龈下厌氧菌繁殖增加。

Objective To explore the effect of screw fixation and adhesive fixation on the restoration of posterior single crown implant dentures and the influence on the distribution of subgingival flora.Methods 76 patients who were planned to undergo posterior single-crown implant denture restoration in the hospital were selected as the research objects from July 2016 to February 2020.The random number table was used to divide the study group and the control group,with 38 cases in each group.The control group was repaired with screws,and the study group was repaired with adhesive fixation.The patients were followed up for 12 months after the repair.The bone resorption and periodontal health of the implant areas were compared between the two groups,the distribution of subgingival flora and chewing function of the two groups of implants were analyzed,and the stability and bone density of the two groups of implant dentures were counted.Results There was no significant difference in bone resorption between the two groups at 3 months and 12 months after repair(P>0.05).There was no significant difference in gingival sulcus bleeding index(SBI),plaque index(PLI),and probing depth(PD)between the two groups at 3 months and 12 months after restoration(P>0.05).There was no significant difference in the numbers of Melanogenic bacteria and Actinobacillus with actinomycetes between the two groups at 12 months after restoration(P>0.05).The numbers of Anaerobic bacteria and Fusobacterium nucleatum in the study group were both higher than the control group at 12 months after restoration(P<0.05).There was no significant difference in the electrical activity of the masseter muscle between the two groups at 3 months,12 months at rest,and at maximum force bite(P>0.05).There was no statistically significant difference in the stability coefficient value of implant dentures and the alveolar bone density between the two groups at 12 months after restoration(P>0.05).Conclusion Both screw fixation and adhesive fixation are effective methods for the restoration of posterior single crown implant dentures.The short-term effects of the two fixation methods are similar,but the adhesive fixation repair may increase the subgingival anaerobic bacteria reproduction.