拔牙后上颌前牙区不翻瓣即刻种植的修复及美学效果观察

Observation of the Restoration Effect and Aesthetic Effect of Immediate Implantation in the Maxillary Anterior Tooth Area without Flap after Tooth Extraction

目的:将不翻瓣即刻种植用于上颌前牙区拔牙后患者并观察其修复及美学效果。方法:选取80例在笔者医院行上颌前牙区拔牙患者,随机分为翻瓣组(40例)和不翻瓣组(40例)。翻瓣组:给予患者翻瓣即刻种植修复;不翻瓣组:给予患者不翻瓣即刻种植修复。比较两组手术相关指标,种植体周围牙周组织情况[改良出血指数(Modified bleeding index,mSBI)、改良菌斑指数(Modified plaque index,mPLI)、牙周探诊深度(Probing depth,PD)、龈乳头指数(Papila index score,PIS)],骨吸收情况,美学效果[红色美学指数(Pink esthetic score,PES)、白色美学指数(White esthetic score,WES)]及不良反应发生情况。结果:不翻瓣组的术后肿痛时间、手术时间及抗生素使用时间均明显低于翻瓣组(P<0.05);与修复即刻比较,两组修复后6个月mSBI、mPLI、PIS、PD均明显升高(P<0.05),但不翻瓣组患者明显低于翻瓣组(P<0.05);两组修复后6个月骨吸收量均明显高于修复后3个月(P<0.05),但不翻瓣组患者修复后3个月、6个月骨吸收量均低于翻瓣组(P<0.05);与修复即刻比较,两组修复后6个月PES评分、WES评分均明显升高(P<0.05),且与翻瓣组比较,不翻瓣组明显升高(P<0.05);不翻瓣组不良反应生率(5.00%)明显低于翻瓣组(25.00%)(P<0.05)。结论:不翻瓣即刻种植用于上颌前牙区拔牙后患者可有效改善牙周组织情况,减少骨吸收,促进术后修复,美学及修复效果较好,安全有效。

Objective Immediate implantation without flap was used for patients after tooth extraction in the maxillary anterior tooth area,and the restoration effect and aesthetic effect were observed.Methods Eighty patients who underwent tooth extraction in the maxillary anterior tooth area were randomly divided into flap group(40 cases)and non-flap group(40 cases).Among them,the flap group was given immediate planting and repair,and the non-flap group was immediately planted and repaired without flap.The two groups of surgery-related indexes,periodontal tissue around the implant[modified bleeding index(mSBI),modified plaque index(mPLI),periodontal depth(PD),papila index score(PIS)],bone resorption,aesthetic effect[red aesthetic score(pink esthetic score(PES),white esthetic score(WES)]and the occurrence of adverse symptoms.Results The postoperative swelling and pain time,operation time and antibiotic use time in the flap group were significantly lower than those in the flap group(P<0.05).Compared with immediate repair,mSBI,mPLI,PIS,and PD were significantly increased after 6 months of repair in the two groups(P<0.05),but the non-flap group was significantly lower than that in the flap group(P<0.05).The bone resorption in the two groups after 6 months of repair was significantly higher than that after 3 months of repair(P<0.05),but the bone resorption in the non-flap group after 3 months and 6 months was lower than that in the flap group(P<0.05).Compared with immediate repair,the PES score and WES score of the two groups increased significantly after 6 months of repair(P<0.05),and compared with the flap group,the non-flap group increased significantly(P<0.05).The incidence of adverse symptoms in the flap group(5.00%)was significantly lower than that in the flap group(25.00%)(P<0.05).Conclusion Immediate implantation without flap can effectively improve periodontal tissue,reduce bone resorption,promote postoperative restoration,and have good aesthetic effects and restoration effects,safe and effective.