牙槽突扩张术联合GBR植骨术同期种植牙在骨宽度严重不足患者中的应用效果

Application effects of simultaneous dental implant treatment with alveolar process expansion combined with GBR grafting on patients with severely deficient bone width

目的 探讨牙槽突扩张术联合引导骨再生(GBR)植骨术同期种植牙在骨宽度严重不足患者中的应用效果。方法 选取2016年10月—2020年10月安徽中医药大学附属滁州中西医结合医院收治的123例骨宽度严重不足患者为研究对象,根据手术方式不同分为观察组(n=66)和对照组(n=57)。观察组实施牙槽突扩张术联合GBR植骨术同期种植牙治疗,对照组实施传统牙槽骨劈开术同期种植牙治疗。比较两组患者术后骨愈合时间,术前、术后1年种植体周围骨吸收量(近中吸收量、远中吸收量),术后1年内并发症发生率及患者主观感受评分(固位功能、咀嚼功能、美观度、舒适度)。结果 观察组术后骨愈合时间短于对照组(P<0.05);术后1年,两组患者种植体周围牙槽骨近中吸收量、远中吸收量均较术前降低,且观察组低于对照组(P<0.05);术后1年内,观察组并发症总发生率低于对照组(P<0.05);术后1年,观察组主观感受评分固位功能、咀嚼功能、美观度、舒适度均高于对照组(P<0.05)。结论 牙槽突扩张术联合GBR治疗骨宽度严重不足疗效确切且并发症少,术后患者固位功能、咀嚼功能及美观舒适度主观感受更佳。

Objective To observe the application effects of simultaneous dental implant treatment with alveolar process expansion combined with guided bone regeneration(GBR)grafting on patients with severely deficient bone width.Methods The case data of 123 patients with severely deficient from 2016.10 to 2020.10 at Chuzhou Traditional Chinese Medicine Hospital Affiliated to Anhui University.Among them,66 cases underwent simultaneous dental implant treatment with alveolar process expansion combined with GBR bone grafting and were included in observation group,and 57 cases underwent simultaneous dental implant treatment with traditional alveolar bone dissection and were included in control group.The postoperative bone healing time,bone resorption around the implant(proximal resorption,distal resorption)before surgery and at 1 year after surgery,incidence rates of complications within 1 year after surgery and patient's subjective feelings scores(retention function,masticatory function,aesthetics,comfort)were compared between the two groups.Results The postoperative bone healing time in observation group was shorter than that in control group(P<0.05).At 1 year after surgery,the proximal resorption and distal resorption of alveolar bone around the implant in the two groups were decreased compared with those before surgery,and the two indicators in observation group were lower than those in control group(P<0.05).The total incidence rate of complications in observation group within 1 year after surgery was lower than that in control group(P<0.05).At 1 year after surgery,the subjective feelings scores of retention function,masticatory function,aesthetics and comfort in observation group were higher than those in control group(P<0.05).Conclusion Alveolar process expansion combined with GBR bone grafting has an exact efficacy,few complications and good postoperative subjective feelings of retention function,masticatory function and aesthetic comfort in the treatment of patients with severely deficient bone width.