前牙美学区牙槽嵴保存延期种植的临床研究

目的探讨前牙美学区即刻拔牙后采用牙槽嵴保存技术对延期种植的美学修复影响。方法收集选取2016—2018年于南京医科大学附属口腔医院就诊的患者20例,其中男8例、女12例,所有患者美学区无法保留患牙且骨质缺损较严重,需行前牙美学修复,行前牙微创拔牙,拔牙后即刻行植骨术和胶原膜隔离,引导拔牙窝骨再生,实现位点保存。6个月后摄片测量牙槽嵴骨量增量情况,植入种植体,术后3~6个月完成最终上部修复。观察种植修复效果,包括红色美学指数(PES)、牙冠白色美学指数(WES)、牙槽嵴宽度和高度等,应用SPSS 16.0进行描述性统计分析。所有病例随访3年观察修复疗效。结果前牙种植美学修复PES/WES总均值为15.17±3.2,PES的均值为7.53±1.68,WES的均值为7.64±1.52。种植体周围骨垂直吸收速率平均0.45毫米/年以下,修复后达到了满意的美学效果。结论对于骨质缺损较严重的前牙美学区,前牙区拔牙后牙槽嵴保存术实现了良好的骨增量,维持了牙槽嵴宽度和高度,拔牙后牙槽嵴保存术加延期种植是保证种植成功的有效方法。

Clinical study of alveolar ridge preservation technology in the postponed implant in aesthetic area

Objective To investigate the effect of alveolar ridge preservation technique on the aesthetic restoration of delayed implant after immediate extraction of anterior teeth.Methods A total of 20 patients(8 males and 12 females)were selected from the Stomatological Hospital Affiliated to Nanjing Medical University from 2016 to 2018.All patients were unable to retain the affected teeth in the aesthetic area and had serious bone defects.Aesthetic restorations of the anterior teeth were needed.Minimally invasive extraction of the anterior teeth was performed.Bone grafting and collagen membrane isolation were performed immediately after extraction to guide bone regeneration of the extraction socket and achieve site preservation.Six months later,the bone mass increment of alveolar ridge was measured by radiography,and implants were placed.The final restorations were completed 3?6 months after operation.The effects of implant restoration,including pink aesthetic index(PES),white aesthetic index(WES),width and height of alveolar ridge,were observed and analyzed by SPSS 16.0.All patients were followed up for 3 years.Results The total mean value of PES/WES was 15.17±3.2,while the mean value of PES and WES was 7.53±1.68 and 7.64±1.52,respectively.The average vertical absorption rate of peri?implant bone was less than 0.45 mm/year,and the aesthetic effect was satisfactory.Conclusions For the aesthetic area with serious bone defect,alveolar ridge preservation after tooth extraction can achieve good bone increment and maintain the width and height of alveolar ridge.Alveolar ridge preservation and delayed implantation after tooth extraction are reliable for implant succuss.