前牙即刻种植和常规种植修复2年后软、硬组织稳定性比较

目的：比较前牙区即刻种植和常规种植两组病例在修复2年后其软、硬组织稳定性的差异。方法：选择2010 年10月至2011 年12月来北京大学口腔医院第二门诊部就诊的拟在前牙区1～2颗不相邻的牙位进行种植治疗的健康患者38名，共植入43颗种植体。在行种植上部修复前均采用种植体支持的临时冠进行牙龈形态的诱导，直至永久修复完成。在修复即刻及2年后测量近远中牙龈乳头、唇侧龈缘水平高度以及种植体近远中侧骨水平的变化。结果：前牙即刻种植组完成16例，植入种植体17颗；常规种植组完成22例，植入种植体26颗。两组病例在永久修复前种植体稳定性系数值（implant stability quotient，ISQ）差异无统计学意义（P>0.05）。即刻种植组和常规种植组在修复2年后近中龈乳头高度平均增高分别为（0.15±0.42）mm和（0.06±0.65）mm，远中龈乳头高度平均增高分别为（0.06±0.50）mm和（0.02±0.57）mm；唇侧龈缘水平平均丧失分别为（0.15±0.23）mm和（0.15±0.46）mm；种植体骨吸收量在近中侧分别为（0.67±0.35）mm和（0.69±0.49）mm，远中侧分别为（0.73±0.31）mm和（0.75±0.48）mm；两组间差异均无统计学意义（P>0.05）。结论：两组病例在修复后2年内都显示出良好的效果，其软、硬组织均很稳定，提示这两种方法都可以获得可靠的修复效果。在严格掌握适应征的前提下，前牙区的即刻种植与常规种植在修复后的近期效果相当，但即刻种植在缩短疗程方面显然要优于常规种植。

Comparison of soft and hard tissue stability between immediate implant and delayed implant in maxillary anterior region after loading 2 years

Objective: To compare the peri-implant tissue stability between immediate implant and delayed implant in maxillary anterior region after loading 2 years.Methods: In the study, 38 patients with single anterior tooth loss in the Second Clinical Division of Peking University School and Hospital of Stomatology from October 2010 to December 2011 were enrolled , and 43 implants were inserted .The gin-gival contour was induced using implant-supported temporary crowns prior to restoration till permanent prostheses delivered .The gingival papilla height , labial gingival margin level and peri-implant bone level were measured immediately after the permanent restoration and 2 years later .Results: In the study , 16 patients were treated by immediate implant for 17 implants;22 patients were treated by delayed im-plant for 26 implants .The implant stability quotient ( ISQ ) value of the 2 groups showed no significant difference before permanent restoration (P>0.05).In all the cases after loading 2 years, the average mesial gingival papilla height in the implant area of the immediate group and delayed group increased by (0.15 ±0.42) mm and (0.06 ±0.65) mm, respectively;the distal gingival papilla height increased by (0.06 ±0.50) mm and (0.02 ±0.57) mm respectively;while the labial gingival margin level shrinka-ges were (0.15 ±0.23) mm and (0.15 ±0.46) mm, respectively.The peri-implant bone losses in the mesial side were (0.67 ±0.35) mm and (0.69 ±0.49) mm, respectively, while in the distal side were (0.73 ±0.31) mm and (0.75 ±0.48) mm, respectively.All these indicators showed no significant difference between the 2 groups ( P>0 .05 ) .Conclusion:Both the cases obtained optimizer results after loading 2 years, and the soft and hard tissues around the implant were very stable , which means that both the protocols can achieve reliable therapeutic effects .If we can handle the indications , immediate implant for anterior teeth shows similar efficacy with delayed implant in the short term .But immediate implant in terms of shortening the course of treatment is clearly superior to delayed implant .