改良盾构术与不翻瓣即刻种植在前牙美学区即刻种植修复中的效果比较

Comparison of the effects of modified socket shield technique and flapless immediate implantat placement in the aesthetic area of anterior teeth for immediate implant restoration

目的比较改良盾构术与不翻瓣即刻种植在前牙美学区即刻种植修复中的效果。方法选取东南大学医学院附属南京同仁医院及南京建邺区沁橙口腔门诊部2021年4月~2022年4月收诊的122例前牙缺损患者,共计患牙122颗。采用随机数字表法分为对照组和研究组,每组61例。对照组采用不翻瓣即刻种植治疗,研究组采用改良盾构术治疗,比较术后12个月两组的种植成功率、牙体美学评分、种植体邻近骨吸收状况及患者满意度,记录患者术后并发症发生状况及术后1周内疼痛程度。结果术后12个月两组患者种植体成功率均为100%,差异无统计学意义(P>0.05)。术后12个月研究组牙体美学评分高于对照组(P<0.05)。术后1周两组患者的疼痛程度评分均降低(P<0.05),组间比较差异无统计学意义(P>0.05)。术后12个月研究组唇侧颈部、距唇侧颈部2 mm处及距唇侧颈部4 mm处的骨板厚度均高于对照组(P<0.05);对照组唇侧颈部、距唇侧颈部2 mm处及距唇侧颈部4 mm处的骨板厚度较术后即刻均降低(P<0.05)。研究组患者的治疗满意度优于对照组(P<0.05)。两组患者均未出现严重并发症。结论改良盾构术与不翻瓣即刻种植应用于前牙美学区即刻种植修复中,种植成功率均较高,而改良盾构术更有助于减少术后牙槽骨吸收,提高牙体美学及患者满意度。

Objective To compare the effects of modified socket shield technique and flapless immediate implantation in the aesthetic area of anterior teeth.Methods A total of 122 patients with anterior tooth defects in Affiliated Nanjing Tongren Hospital of Southeast University School of Medicine and Qin Orange Dental Clinic from April 2021 to April 2022 were selected,involving 122 teeth.They were divided into control group and study group by using a random number table,with each group of 61 patients.Control group were treated with flapless immediate implantation,while the study group were treated with modified socket shield technique.After 12 months postoperatively,the implant success rate,dental aesthetic score,peri-implant bone absorption status,and patient satisfaction were compared between the two groups.Additionally,postoperative complications and pain levels within 1 week after surgery were recorded for each patient.Results At 12 months after surgery,the success rate of implants in both groups of patients was 100%,with no statistically significant difference(P>0.05).At 12 months after surgery,the dental aesthetic score in the study group was higher than that in the control group(P<0.05).One week after surgery,the pain score of both groups of patients decreased(P<0.05),and there was no statistically significant difference between the two groups(P>0.05).At 12 months after surgery,the bone plate thickness at the labial neck,2 mm from the labial neck,and 4 mm from the labial neck in the study group was higher than that in the control group(P<0.05);The thickness of bone plates at the labial neck,2 mm from the labial neck,and 4 mm from the labial neck in the control group decreased immediately after surgery(P<0.05).The treatment satisfaction of the study group patients was better than that of the control group(P<0.05).Both groups of patients did not experience serious complications.Conclusion The application of modified socket shield technique and flapless immediate implantation in the aesthetic area of anterior teeth has a high success rate of implantation.The improved shield tunneling is more helpful to reduce the postoperative alveolar bone resorption,improve the tooth aesthetics and patient satisfaction.