上颌中切牙即刻种植术后骨量变化的影响因素探讨

Analysis of factors affecting bone volume changes after immediate implantation in the maxillary central incisor

目的 探讨单颗上颌中切牙即刻种植的临床效果及术后种植体周骨量的影响因素。方法 选取接受单颗上颌中切牙即刻种植治疗的100例患者(100枚种植体)为研究对象,收集患者临床资料及术前、术后当天和术后6个月影像学资料。测量术后即刻和术后6个月的种植体唇腭侧颈部、中部和根部的骨板厚度,观察骨量变化的规律,并通过回归分析模型评估唇腭侧骨板厚度的预测因素。结果 术后6个月,种植体颈部、中部和根部唇侧骨厚度分别为2.35、2.29和3.28 mm,腭侧分别为0.00、2.40和6.05 mm;颈部骨吸收率最高,唇侧和腭侧分别为32.87%和62.20%;回归分析模型显示,种植体颈部唇侧骨厚度的影响因素为种植体颈部唇侧初始骨厚度、横断面上种植体中心与两邻牙中心连线夹角、种植体直径和愈合方式(P<0.05),而种植体腭侧初始骨厚度为种植体腭侧骨厚度的唯一预测因素(P<0.05)。结论 单颗上颌中切牙即刻种植临床效果良好,种植体周新生骨厚度受多种因素共同影响,在制定即刻种植方案时,需综合考虑这些因素以达到最佳治疗效果。

Objective This study aimed to evaluate the clinical outcomes of immediate implantation of single maxillary central incisor and explore factors affecting post-implant bone volume.Methods Clinical data and imaging records from pre-surgery,the day of surgery,and 6 months post-surgery of 100 patients(100 implants) with non-salvageable maxillary central incisors who underwent immediate implantation were collected.Bone thickness at the cervical,middle,and apical regions of the implant's labial and palatal sides were measured immediately post-surgery and at 6 months,and bone volume changes were observed.A regression analysis model was used to assess predictive factors for labial and palatal bone plate thickness.Results At 6 months post-surgery,the labial bone thicknesses at the cervical,middle,and apical regions were 2.35,2.29,and 3.28 mm,respectively,and those of the palatal side were 0.00,2.40,and 6.05 mm,respectively.The cervical region had the highest alveolar crest collapse rates,with 32.87% on the labial side and 62.20%on the palatal side.The regression model indicated that factors influencing the thickness of bone at the cervical labial side of the implant included initial bone thickness,the implant center to adjacent tooth center angle,implant diameter,and the type of implant closure(P<0.05).The initial bone thickness on the palatal side was the sole predictor for bone thickness on the palatal side(P<0.05).Conclusion Immediate implantation of single maxillary central incisors yields effective clinical results.The thickness of new bone around the implant is influenced by multiple factors.A comprehensive consideration of these factors in the planning of immediate implantation is necessary to achieve optimal therapeutic outcomes.