微种植支抗螺钉不同植入部位的比较

背景:合理地使用微型种植支抗螺钉作为正畸治疗中的绝对支抗,代替需要患者高度配合且影响美观的传统支抗,目前受到越来越多的关注.目的:对比观察在3个不同部位植入微型种植支抗螺钉(简称微螺钉)后的变化.设计、时间及地点:临床分组对照实验,病例来自于2004-01/2007-12佛山科学技术学院附属口腔医院.对象:筛选出上颌需要最大支抗的固定矫正患者45例,分为3组:游离龈区域植入组,膜龈联合处植入组,黏膜区域植入组.方法:采用不完全翻瓣微螺钉植入方法,分别在膜龈联合靠近附着龈区域、游离龈处及黏膜区域植入微螺钉,每组30枚.主要观察指标:①微螺钉松动脱落情况.②术后7 d微螺钉植入患者进行疼痛时间和疼痛程度检测.③术后56d微螺钉周围软组织指数和探诊出血阳性率.结果:①游离龈区域组微螺钉松脱数最高(9枚).膜龈联合处组松脱数最少(2枚).②微螺钉植入术后黏膜区红肿疼痛及患者不舒适感较强烈;游离龈区域反应轻微;膜龈联合处反应不十分明显,但术后疼痛程度较游离龈区域重.③黏膜区域组探诊出血阳性率和微螺钉周围软组织指数岛于游离龈区域组和膜龈联合处组(P<0.05).结论:在膜龈联合近附着龈区域采用不完全翻瓣微螺钊植入法,有利于其提高植入成功率、降低炎症程度及防止潜在风险的发生.

Comparison of micro-implant screw anchorage at various implant areas

BACKGROUND: Micro-implant screws as an absolute anchorage, instead of traditional anchorage that requires patient's high matching and affects beauty, has been paid more attention.OBJECTIVE: To compare the changes in 3 different places following implantation of micro-implant screws. DESIGN, TIME AND SETTING: The controlled study was performed at the Hospital of Stomatology Affiliated to Foshan College of Sciences and Technology from January 2004 to December 2007.PARTICIPANTS: A total of 45 patients who demand powerful anchorage during the orthodontic treatment were assigned to 3 groups: free gingiva group, mucogingival junction group, and mucosa group.METHODS: By using incomplete flap micro-implant screw implantation, micro-implant screws were implanted in the free gingiva, mucogingival junction and mucosa, with 30 screws in each area.MAIN OUTCOME MEASURES: Loosening and defluvium of micro-implant screws were measured. Pain duration and degree were determined in patients undergoing implantation of micro-implant screws 7 days following surgery. Soft tissue surrounding the micro-implant screws and bleeding rate during probing were detected 56 days following surgery.RESULTS: The number of screw loosening was greatest in the free gingiva group (9 screws), while lowest in the mucogingival junction group (2 screws). Patients suffered from severe flare and pain in the mucosa, and the reaction was mild in the free gingiva following implantation. The reaction was not obvious, but severe pain was found in the mucogingival junction following implantation compared with the free gingiva. Soft tissue surrounding the micro-implant screws and bleeding rate during probing were greater in the mucosa group than in the free gingiva group and mucogingival junction group (P<0.05).CONCLUSION: The incomplete flap micro-implant screws in the mucogingival junction contribute to the increase in success implantation rate and the decrease in inflammatory degree, and prevent the occurrence of potential risk.