根尖切除术对种植体伴慢性根尖周炎骨修复的影响

目的 探讨根尖切除术对于种植体伴邻牙慢性根尖周炎病例的骨组织修复及愈合的影响研究。方法 选择2017年12月至2018年6月符合种植适应证，且种植区邻牙伴有慢性根尖周病变的患者22例。随机分为实验组和对照组，每组11例。实验组在行种植手术的同时，对邻牙的根尖周病变行根尖切除手术及根管治疗术。对照组则进行种植手术，对邻牙的根尖周病变行常规根管治疗术。术后6个月及1年复诊，追踪观察种植体与邻牙根尖周病变的状况，进行统计学分析。结果 临床检查显示，根尖病变患牙对照组1例出现松动度，1例出现牙周袋，与实验组相比，P<0.05；种植体在实验组及对照组均无临床症状，P>0.05。影像学检查显示，根尖病变患牙实验组中两组骨愈合率无统计学差异；种植体对照组中，2例种植体无骨结合，两组间有统计学差异，P<0.05。术后1年，临床检查结果显示，根尖病变患牙对照组各1例患者出现黏膜红肿及窦道、脓肿，与实验组相比，P<0.05；种植体对照组中，分别各1例出现叩、触诊异常，松动，牙周袋，两组间有统计学差异，P<0.05。影像学检查显示，根尖病变患牙实验组中两组骨愈合率无统计学差异；种植体实验组中，11例种植体骨结合正常，对照组中，1例种植体无骨结合，与对照组比较差异有统计学意义，P<0.05。结论 在种植体邻牙伴有慢性根尖周炎时，在实施种植手术的同时，对邻牙进行根尖切除术，有利于种植体的骨修复和提高临床种植成功率。

Effect of apical resection on bone repair of implants with chronic apical periodontitis

Objective To investigate the effect of apical resection on bone repair of implants with chronic apical periodontitis. Methods Twenty-two patients with periapical lesions in the implanted area were selected for implant surgery. The patients were divided into experimental group and control group. The experimental group received apical resection of the periapical lesions of the adjacent teeth at the same time as the implantation surgery. In the control group, only the implantation surgery was performed. The patients were followed up for 6 months and 1 year after surgery. The status of the implants and the periapical lesions of the adjacent teeth were followed up and statistical analysis was performed. Results Clinical examination revealed that 1 case of apical lesions had looseness and 1 case had periodontal pockets in the control group compared with the experimental group (P<0.05). There were no clinical symptoms in the experimental group and the control group (P>0.05). Imaging studies revealed that there was no significant difference in bone healing rate between the two groups in the apical lesions. In the control group, 2 implants had no bone binding, and the experimental group had normal bone binding. There were statistical differences between the two groups (P<0.05). One year after surgery, clinical examination indicated that 1 case of apical lesions in the control group had mucosal redness, sinus and abscess compared with the experimental group (P<0.05); 1 case in the control group had palpation abnormalities, loosening, periodontal pockets, there was a statistical difference between the two groups (P<0.05). Imaging studies revealed no significant difference in bone healing rate between the two groups in the apical lesions. In the experimental group, 11 implants were normal in bone binding, and in the control group, 1 implant had no bone binding. The difference between the two groups was statistically significant (P<0.05). Conclusion For patients with apical periodontitis in the implanted area, apical resection of the periapical lesions of the adjacent teeth at the same time as the implantation surgery is beneficial to the bone repair of the implants and improves clinical success rate.