根壁保留技术在上颌前牙美学区种植中的应用及对牙龈形态的影响

Esthetic outcomes of socket-shield technique for immediate implantation in the maxillary anterior zone and its effect on gingival morphology

目的观察保留根壁技术(SST)在上颌前牙美学区种植中的应用效果及其对牙龈形态的影响。方法选取湖州市中心医院2019年1月至2021年9月收治的上颌牙列缺失患者75例进行病例对照研究,根据治疗方法将患者分为SST组(采用SST技术行上颌牙美学区种植,n=30)与即刻组(行即刻种植,n=45)。术后随访1年,比较两组术区唇侧骨板厚度、红色美学参数(PES)、牙周探诊深度及患者满意度。结果SST组术后6个月、12个月唇侧骨板厚度吸收分别为(0.24±0.07)mm、(0.41±0.10)mm,均显著低于即刻组的(0.56±0.11)mm、(0.86±0.15)mm(t=14.12、14.41,均P<0.001);SST组术后6个月、12个月,PES量表中唇侧龈缘曲度、高度及颜色、质地评分均显著高于即刻组(t_(6个月)=7.13、6.38、5.45、4.92,t_(12个月)=3.43、2.92、7.50、6.25,均P<0.05),两组各时间段近中牙乳头及远中牙乳头评分差异均无统计学意义(均P>0.05);SST组术后6个月牙周探诊深度为(1.21±0.06)mm,显著低于即刻组的(1.92±0.07)mm(t=45.49,P<0.001),术后12个月,两组牙周探诊深度差异无统计学意义(P>0.05);两组患者满意度差异无统计学意义(P>0.05)。结论SST可有效解决唇侧骨量不足问题,避免唇侧骨量吸收,在恢复唇侧牙槽突形态及软组织水平中具有一定的优势,其临床应用效果与即刻种植相似。

Objective To investigate the esthetic outcomes of socket-shield technique(SST)for immediate implantation in the maxillary anterior zone and its effect on gingival morphology.Methods This case-control study included 75 patients with maxillary anterior tooth defects who were treated at Huzhou Central Hospital between January 2019 and September 2021.Based on their respective treatment methods,these patients were divided into two groups:SST implantation(n=30)and immediate implantation(n=45).All patients were followed up for 1 year.During this period,the thickness of the labial plate,pink esthetic score,probing depth,and patient satisfaction were compared between the two groups.Results At 6 and 12 months post-surgery,the SST group exhibited significantly lower labial plate bone resorption[(0.24±0.07)mm,(0.41±0.10)mm]compared with the immediate implantation group[(0.56±0.11)mm,(0.86±0.15)mm,t=14.12,14.41,both P<0.001].Furthermore,at both time points,the SST group scored significantly higher in curvature,height,color,and texture of the labial gingival margin using the pink esthetic score scale(t_(6 months)=7.13,6.38,5.45,4.92;t_(12 months)=3.43,2.92,7.50,6.25,all P<0.05).The mesial and distal papilla scores did not differ significantly between the SST and immediate implantation groups at various time points(all P>0.05).However,at 6 months post-surgery,the periodontal probing depth in the SST group was(1.21±0.06)mm,which was significantly lower than the corresponding value of(1.92±0.07)mm in the immediate implantation group(t=45.49,P<0.001).By 12 months post-surgery,no significant difference in periodontal probing depth was observed between the two groups(P>0.05).Additionally,there was no significant difference in patient satisfaction between the SST and immediate implantation groups(P>0.05).Conclusion SST effectively addresses insufficient labial bone mass and prevents bone resorption.Additionally,it is advantageous for restoring the morphology of the labial alveolar process and soft tissue level.Clinically,its application produces similar results to immediate implantation.