牙槽嵴保存术对不同牙槽骨缺损患者延迟种植效果的影响

目的:探讨牙槽嵴保存术对不同牙槽嵴骨缺损患者延迟种植效果的影响。方法:94例行下颌单颗后牙拔除术患者,根据牙拔除术前牙槽嵴骨缺损量不同将患者分为轻度组(n=53)和中重度组(n=41),行拔牙术后再将轻度组和中重度组分别随机分为保存术组和对照组,保存术组对牙槽窝采取牙槽嵴保存术,对照组对牙槽窝不做处理。结果:轻度组和中重度组患者术后6个月保存术组患者宽度减少量和高度减少量均小于对照组(P<0.05);轻度组和中重度组中保存术组和对照组患者术后6月时GRL较拔牙前增加,而PD和AL则较拔牙前减少;轻度组种植体直径4.1 mm和4.8 mm分别占26.4%和73.6%,而中重度组则分别为46.3%和53.7%,两组相比差异具有统计学意义(χ²=4.029,P=0.045);轻度组种植体长度分布与中重度组相比差异具有统计学意义(χ²=21.207,P=0.000)。结论:牙槽嵴保存术可有效减少拔牙术后植骨区牙槽嵴骨量损失,有利于延迟种植操作的开展,尤其对患牙拔除前牙槽嵴骨缺损量>5 mm的患者,效果尤为显著。

Effects of Alveolar Ridge Preservation on Delayed Implantation for Patients with Different Alveolar Crest Bone Defects

Objective: To investigate effects of alveolar ridge preservation on delayed implantation for patients with different alveolar crest bone defects. Methods: According to the extent of alveolar bone defect before single mandibular posterior tooth extraction, ninety-four patients were divided into two groups: mild group (n=53), 3-5mm alveolar bone defect; moderate and severe group (n=41), >5mm alveolar bone defect. After tooth extraction, each group was further randomly divided into two subgroups: patients with (the trial group) or without (the control group) alveolar ridge preservation. Results: After 6 months, compared to the control groups, the width and height reduction of the alveolar ridge bone in each subgroup was less in the trial groups (P<0.05). Compared with situation before tooth extraction surgery, the gingival recession levels (GRLs) increased in each group, while pocket depth (PD) and attachment loss (AL) decreased. The ratios of 4.1mm and 4.8mm implants in diameter in mild group were respectively accounted for 26.4% and 73.6%, while the ratios were 46.3% and 53.7% in the moderate and severe group. The difference between two groups was statistically significant (χ²=4.029, P=0.045). The difference of distributions of implant length between the mild group and moderate and severe group was also statistically significant (χ²=21.207, P=0.000). Conclusion: The alveolar ridge preservation technique could effectively reduce the alveolar ridge bone loss in the graft area after tooth extraction, which was conducive to delay implantation operation, especially for patients with alveolar ridge bone defect >5mm before tooth extraction.