上前牙相邻种植体间黑三角出现情况的临床研究

Clinical study on the appearance of black triangle between the adjacent implants of upper anterior teeth

目的:通过回顾性调查分析上前牙种植体间距、牙冠接触点位置高低对植体间黑色三角区出现的影响。方法:选取2017年9月-2021年8月于内蒙古自治区人民医院行上前牙连续种植修复并符合纳入标准患者74人,龈乳头共计86例,根据有无出现黑三角的情况,将患者分两组。然后分别记录各组种植体间的水平距离和牙冠龈端邻接点到牙槽骨垂直距离,分析种植体间的水平距离和牙冠龈端邻接点到牙槽骨垂直距离对黑三角的影响。根据植体间距将水平距离分为两组,Ⅰ组:≤4 mm;Ⅱ组:>4 mm。根据牙冠接触点距牙槽嵴顶距离将垂直距离分为两组:A组:3 mm~5 mm,B组:>5 mm。分析各组间黑三角出现情况有无差异。结果:未出现黑三角的60例龈乳头中,水平距离为(4.14±0.44)mm,垂直距离为(3.68±0.63)mm,出现黑三角的26例龈乳头中,水平距离为(3.73±0.55)mm,垂直距离为(5.14±0.46)mm,二组数据均有统计学意义(α=0.05,P<0.05)。对不同水平距离分组的黑三角出现情况进行卡方检验,两组间黑三角出现率有差别(χ^(2)=6.753,P<0.05),Ⅱ组恢复率较好,为78.9%;对不同垂直距离分组的黑三角出现情况进行卡方检验,两组间黑三角出现率有差别,且差异显著(χ^(2)=48.308,P<0.05)A组恢复率较好,为91.8%。logistic回归分析得出,水平距离(≤4 mm)B值为1.913,P<0.05,OR值为6.773;垂直距离(>5 mm)B值为4.433,P<0.05,OR值为84.209。结论:水平距离≤4 mm与垂直距离>5 mm均是影响黑色三角区出现的因素,其中水平距离在此范围内,距离越小时,黑三角越容易出现,垂直距离在(3.68±0.63)mm时黑三角不易出现,但可能并不是龈乳头高度恢复的极限。垂直距离>5 mm时黑三角容易出现,且较其他因素更容易导致黑三角的产生。

Objective:Basing on the retrospective investigation,we analyzed the influence of distance between upper anterior dental implants,the influence of the position of contact point between dental crowns on the appearance of black triangle.Methods:74 patients were selected to receive continuous implant restoration of anterior teeth in People's Hospital of Inner Mongolia Autonomous Region from September 2017 to August 2021.According to the occurrence of black triangle,74 patients with 86 gingival papilla were divided into two groups:No Black Triangle Group and Black Triangle Group.Then the implantsvalues of between the horizontal distance,the vertical distance from adjacent point of crown gingival end to alveolar bone were recorded separately in both groups,and the effects of the horizontal and vertical distances between the implants on the black triangle were analyzed.According to the implant spacing,the horizontal distance was divided into two groups:group I:≤4 mm;group II:>4 mm.According to the distance between the contact point of crown and the alveolar crest,the vertical distance was divided into two groups:group A:3 mm~5 mm,group B:>5 mm.Analyze whether there are differences in the appearance of black triangle among the groups.Results:The horizontal distance was(4.14±0.44)mm and the vertical distance was(3.68±0.63)mm in the 60 patients without black triangle;the horizontal distance was(3.73±0.55)mm and the vertical distance was(5.14±0.46)mm in the 26 patients who presented with black triangles.The two data sets were statistically significant(α=0.05,P<0.05);Chi square test was conducted for the appearance of black triangle grouped by different horizontal distance,and the appearance rate of black triangle was different between the two groups(χ^(2)=6.753,P<0.01),the recovery rate in group II was better,78.9%;Chi square test was carried out for the appearance of black triangle grouped by different vertical distance,and the appearance rate of black triangle was different between the two groups,and the difference was significant(χ^(2)=48.308,P<0.05)the recovery rate of group A was better,91.8%.logistic regression analysis yielded a horizontal distance(≤4 mm)B value of 1.913,P<0.05,and OR value of 6.773;a vertical distance(>5 mm)B value is 4.433,P<0.05,and OR value of 84.209.Conclusion:When the horizontal distance is≤4 mm and the vertical distance is>5 mm,both are factors leading to the appearance of black triangle.Within this range,the smaller of horizontal distance is,the easier the black triangle is to appear.When the vertical distance is(3.68±0.63)mm,the black triangle is not easy to appear,but it may not be the limit of gingival papilla height recovery.Black triangle with vertical distance>5 mm is easy to appear,and more likely to cause black triangle than other factors.