钛合金种植体与纯钛种植体修复牙列缺损的效果

The effect of titanium alloy implant and pure titanium implant in repairing dentition defect

目的:探讨钛合金种植体与纯钛种植体对牙列缺损的近期和远期治疗效果。方法:选取河南大学淮河医院2019年6月至2022年6月收治的165例牙列缺损作为研究对象,按照接受治疗方式的不同,分为钛合金种植体组和纯钛种植体组,钛合金种植体组患者采用钛合金种植体修复治疗方式,纯钛种植体组患者采用纯钛种植体修复治疗方式。治疗6个月后,分析两组患者龈沟液中炎性因子、吞咽功能、咀嚼功能、发音功能、牙菌斑指数、龈沟出血指数、牙龈指数、牙齿总咬合力、并发症发生率及美学评分相关指标的变化。组间计量数据比较采用独立样本t检验。结果:钛合金种植体组患者治疗有效率[90.24%(74/82)]明显高于纯钛种植体组患者[78.31%(65/83)],差异有统计学意义(χ^(2)=6.487,P<0.05)。钛合金种植体组患者吞咽功能、咀嚼功能、发音功能和牙齿咬合评分[(3.27±0.98)、(3.91±0.85)、(3.32±0.70)、(3.09±0.84)分]明显高于纯钛种植体组[(2.99±0.79)、(2.78±0.86)、(2.32±0.78)、(2.48±0.92)分],差异有统计学意义(t=2.012、8.422、8.614、4.358,P<0.05)。钛合金种植体组患者功能限制、口腔疼痛、社交障碍、心理不适和总分[(3.71±1.16)、(3.02±0.98)、(3.98±1.05)、(3.20±1.10)、(10.54±3.34)分]明显低于纯钛种植体组[(4.76±0.91)、(4.05±1.09)、(4.52±0.96)、(4.47±1.03)、(14.36±3.71)分],差异有统计学意义(t=6.441、6.334、6.670、3.066、6.930,P<0.05)。钛合金种植体组患者牙菌斑指数、龈沟出血指数、牙龈指数[(0.74±0.70)、(0.57±0.52)、(0.80±0.71)分]明显低于纯钛种植体组[(1.31±0.63)、(1.18±0.67)、(1.52±0.53)分],差异有统计学意义(t=5.529、6.413、7.369,P<0.05)。钛合金种植体组患者龈沟液肿瘤坏死因子(TNF)和白细胞介素(IL)-6水平[(14.67±4.89)、(30.65±5.70)ng/ml]明显低于纯钛种植体组[(29.27±5.48)、(61.79±14.75)ng/ml],差异有统计学意义(t=18.010、17.830,P<0.05)。钛合金种植体组患者并发生发生率[8.54%(7/82)]吞咽功能[(3.27±0.98)分]明显低于纯钛种植体组[15.66%(13/83)],差异有统计学意义(χ^(2)=10.541,P<0.05)。结论:钛合金种植体治疗牙列缺损可有效改善患者牙齿功能、改善患者咀嚼和咬合能力,减少牙齿菌斑和种植体周围的炎症水平,提高牙齿的美学效果。

Objective:To investigate the short-term and long-term therapeutic effects of titanium alloy implants and pure titanium implants on dental defects.Methods:A total of 165 cases of dental defect treated in our hospital from June 2019 to June 2022 were selected as the study objects.According to the different treatment methods,they were divided into titanium alloy implant group and pure titanium implant group.Titanium alloy implant group was treated with titanium alloy implant repair treatment,while pure titanium implant group was treated with pure titanium implant repair treatment.After 6 month of treatment,the changes of inflammatory factors,swallowing function,chewing function,articulation function,plaque index,gingival bleeding index,gingival index,total tooth bite force,complication rate and aesthetic score in gingival creval fluid of the two groups were analyzed.The measurement data between groups were compared by independent sample t test.Results:The effective rate of titanium implant group[90.24%(74/82)]was significantly higher than that of pure titanium implant group[78.31%(65/83),χ^(2)=6.487,P<0.05].The scores of swallowing function,chewing function,articulation function and tooth occlusion in titanium implant group[(3.27±0.98),(3.91±0.85),(3.32±0.70),(3.09±0.84)points]were significantly higher than those in pure titanium implant group[(2.99±0.79),(2.78±0.86),(2.32±0.78),(2.48±0.92)points,t=2.012,8.422,8.614,4.358,P<0.05].In the titanium alloy implant group,functional limitation,oral pain,social disturbance,psychological discomfort and total score[(3.71±1.16),(3.02±0.98),(3.98±1.05),(3.20±1.10),(10.54±3.34)points]obviously lower than that of pure titanium implant group[(4.76±0.91),(4.05±1.09),(4.52±0.96),(4.47±1.03),(14.36±3.71)points,t=6.441,6.334,6.670,3.066,6.930,P<0.05].Titanium alloy implant patients plaque index,gingival sulcus bleeding index,gingival index[(0.74±0.70),(0.57±0.52),(0.80±0.71)points]obviously lower than that of pure titanium implant group[(1.31±0.63),(1.18±0.67),(1.52±0.53)points,t=5.529,6.413,7.369,P<0.05].The levels of tumor necrosis factor and interleukin-6 in gingival creval fluid[(14.67±4.89),(30.65±5.70)ng/ml]in titanium implant group were significantly lower than those in pure titanium implant group[(29.27±5.48),(61.79±14.75)ng/ml,t=18.010,17.830,P<0.05].The co-occurrence rate of swallowing function in titanium implant group[8.54%(7/82)]was significantly lower than that in pure titanium implant group[15.66%(13/83)],and the difference was statistically significant(χ^(2)=10.541,P<0.05).Conclusion:Titanium alloy implants can effectively improve the dental function,improve the chewing and occlusal ability of patients,reduce the level of dental plaque and inflammation around the implants,and improve the aesthetic xiaoguo of teeth.