上颌前牙区种植同期GBR术后骨量变化的短期临床研究

A short-term clinical study of bone change after dental implant simultaneous with GBR in maxillary anterior implants

目的:研究上颌前牙区引导骨再生(guided bone regeneration,GBR)同期牙种植术的种植体周围骨量变化及影响因素。方法:收集2018年3月至2021年12月期间,上颌前牙区行种植手术同期GBR的病例20例。术后当天、术后6个月拍摄锥形束CT(cone beam computed tomography,CBCT),统计术后6个月种植体存留率。利用数字化软件3D Ondemand,测量种植体平台下0 mm、3 mm、6 mm、9 mm唇侧、腭侧骨板厚度和唇侧骨高度,对数据进行统计分析。结果:6个月的种植体存留率100%。术后6个月种植体周围的骨量比术后即刻减少,骨量变化有统计学意义(P<0.05)。种植体平台下0 mm、3 mm、6 mm、9 mm唇侧骨板厚度分别减少(1.19±0.90)mm、(0.84±0.93)mm、(0.53±0.64)mm、(0.23±0.62)mm,腭侧分别减少(0.81±0.58)mm、(0.65±0.72)mm、(0.38±0.56)mm、(0.21±0.56)mm,唇侧骨高度减小(1.22±0.74)mm,各位点的骨吸收量差异有统计学意义(P<0.05),唇侧与腭侧的骨吸收量差异均无统计学意义(P>0.05)。结论:前牙区种植同期GBR后种植体周围骨量存在一定程度的吸收,吸收量自冠方向根方逐渐减少。种植体植入时需保证有足够厚度的骨壁。

Objective:To investigate bone changes and influencing factors following dental implant surgery with guided bone regeneration(GBR)in the maxillary anterior area.Methods:From March 2018 to December 2021,20 cases needed dental implant simultaneous with GBR in the maxillary anterior were included.The implant survival rate was calculated6 months after surgery.CBCT was acquired immediately when the operation finished and 6 months after surgery.Buccal bone height and the thickness of the buccal and palatal bone at 0 mm,3 mm,6 mm,9 mm below implant platform was measured respectively by using 3D Ondemand.The data were analyzed using SPSS 25.0 software package.Results:The implant survival rates were 100%after 6 months.The bone changes around the implant was decreased after 6 months of healing,and the changes was statistically significant(P0.05).The thickness of the 0 mm,3 mm,6 mm,and 9 mm of the buccal bone decreased by(1.19±0.90)mm,(0.84±0.93)mm,(0.53±0.64)mm,(0.23±0.62)mm,and the palatal side was decreased by(0.81±0.58)mm,(0.65±0.72)mm,(0.38±0.56)mm,(0.21±0.56)mm respectively,and the buccal bone height decreased by(1.22±0.74)mm.There was a statistically significant difference in the amount of bone resorption at each site(P0.05),but there was no significant difference in the bone resorption between the buccal and palatal sides of every site(P0.05).Conclusion:There is a certain degree of peri-implant bone resorption after GBR with implant surgery in the anterior region,and the absorption gradually decreased from the crown to the root.It is necessary to ensure sufficient bone around the implant when implanting.