个性化牙龈成型器在不同牙龈生物型及角化龈宽度患者上颌单颗前牙种植中的应用效果

Application of personalized gingival molding device in maxillary single anterior tooth implantation in patients with different gingival biotypes and keratinized gingival widths

目的:探讨个性化牙龈成型器在不同牙龈生物型及角化龈宽度患者上颌单颗前牙种植中的应用效果。方法:选择2022年1月—2023年5月绍兴市口腔医院收治的行上颌单颗前牙种植修复的患者85例,按角化龈宽度和牙龈生物型分为4组,角化龈宽度不足和厚龈型组(角化龈宽度<2 cm,n=17)、角化龈宽度不足和薄龈型组(n=13)、角化龈宽度充足和厚龈型组(角化龈宽度≥2 cm,n=26)、角化龈宽度充足和薄龈型组(n=29)。所有患者均接受个性化牙龈成型器种植。比较不同角化龈宽度与牙龈生物型对种植体周围骨组织、软组织美学效果、龈乳头美学效果、软组织愈合程度及美学效果满意度的影响。采用SPSS 23.0软件包对数据进行统计学分析。结果:术后当天、永久修复完成时、永久修复完成6个月后,在相同牙龈生物型条件下,角化龈宽度<2 mm的患者骨吸收量显著大于角化龈宽度≥2 mm的患者(P<0.05)。在相同角化龈宽度下,厚龈型与薄龈型患者骨吸收量比较无统计学差异(P>0.05)。永久修复完成时、永久修复完成6个月后,在相同牙龈生物型条件下,角化龈宽度≥2 mm的患者红色美学指数(PES)评分、龈乳头充填指数(PFI)评分、视觉模拟评分法(VAS)评分显著高于角化龈宽度<2 mm的患者(P<0.05)。在相同角化龈宽度条件下,厚龈型患者PES评分、PFI评分、VAS评分显著高于薄龈型患者(P<0.05)。术后3 d和术后7 d,在相同牙龈生物型条件下,角化龈宽度≥2 mm的患者黏膜肿胀度评分显著低于角化龈宽度<2 mm的患者(P<0.05)。在相同角化龈宽度下,厚龈型患者黏膜肿胀度评分显著低于薄龈型患者(P<0.05)。结论:种植体周围骨组织健康与角化龈宽度密切相关,牙龈生物型对种植体周围骨组织吸收影响较小。角化龈宽度充足且厚龈型患者软组织健康、龈乳头美学效果、软组织愈合程度及美学效果满意度更佳。

PURPOSE:To investigate the effects of personalized gingival formers on bone and soft tissue health and gingival papillae aesthetics around maxillary single anterior dental implants in different gingival biotypes and keratinized gin-gival widths.METHODS:A total of 85 patients who underwent maxillary single anterior tooth implant restoration in Shaoxing Stomatological Hospital from January 2022 to May 2023 were selected and divided into 4 groups according to keratinized gingival width and gingival biotype:insufficient keratinized gingival width and thick gingival type(keratinized gingival width <2 cm,n=17),insufficient keratinized gingival width and thin gingival type(n=13),sufficient keratinized gingival width and thick gingival type(keratinized gingival width ≥2 cm,n=26),sufficient keratinized gingival width and thin gingival type(n=29).All patients received personalized gingival implants.The effects of different keratinized gingival width and gingival biotype on bone tissue,soft tissue aesthetic effect,gingival papilla aesthetic effect,soft tissue healing degree and satisfaction of aesthetic effect were compared.SPSS 23.0 software package was used for data analysis.RESULTS:On the day after surgery,at the completion of permanent repair,and 6 months after the completion of permanent repair,the bone resorption in patients with keratinized gingiva width <2 mm was significantly higher than patients with keratinized gingival width ≥2 mm under the same gingival biological types(P<0.05).There was no significant difference in bone resorption between patients with thick gingival width and patients with thin gingival width under the same keratinized gingival width(P>0.05).At the completion of permanent repair and 6 months after the completion of permanent repair,the pink esthetic scores(PES),gingival papilae filling index(PFI) score and visual simulation score(VAS) of esthetics from patients with keratinized gingival width ≥2 mm were significantly higher than patients with keratinized gingival width <2 mm(P<0.05)under the same gingival biological types.The scores of PES,PFI and VAS in patients with thick gingival type were significantly higher than those in patients with thin gingival type(P<0.05).At 3 and 7 days after surgery,the mucosal swelling score of patients with keratinized gingival width ≥2 mm was significantly lower than that of patients with keratinized gingival width < 2 mm under the same gingival biological types(P<0.05).When the keratinized gingival width ≥2 mm,the mucosal swelling score of patients with thick gingival type was significantly lower than that of patients with thin gingival type 7 days after surgery(P<0.05).CONCLUSIONS:The bone health around the implant is closely related to the keratinized gingival width,and the gingival biotype has little effect on bone resorption around the implant.Patients with full keratinized gingival width and thick gingival type had better satisfaction with soft tissue health,gingival papillae aesthetics,soft tissue healing degree and final aesthetics.