即刻種植與早期種植對前牙種植體周邊軟組織美學效果比較分析

[摘要]目的：探討即刻種植與早期種植的臨床效果及對前牙種植體周邊軟組織的美學效果比較。方法：選取2015年3月-2018年6月筆者醫院收治的上頜前部單牙缺失患者72例，根據隨機數字表法分為即刻種植組和早期種植組，兩組均36例。比較兩組患者修復后1個月、3個月、6個月及12個月的紅色美學指數（pinkethetic score，PES）評分、種植體邊緣骨吸收水平。比較兩組修復后12個月的種植成功率和滿意度。結果：修復后1個月、3個月、6個月及12個月，即刻種植組的PES評分均顯著高于早期種植組（P<0.05）;修復后1個月、3個月、12個月即刻種植組的骨吸收水平與早期種植組相比均無明顯差異（P>0.05），但修復后6個月，即刻種植組的骨吸收水平明顯低于早期種植組（P<0.05）;即刻種植組的種植成功率與早期種植組無明顯差異;即刻種植組的修復后滿意度為97.22%，顯著高于早期種植組的80.56%，有統計學意義（P<0.05）。結論：與早期種植相比，即刻種植可明顯提高前牙種植體周邊軟組織的美學價值，種植成功率及安全性較好，且在降低種植后早期骨吸收水平中可能起作用，在修復后期兩種種植方式的骨吸收水平未顯示出顯著差異。

[關鍵詞]即刻種植;早期種植;種植體;軟組織;美學效果

[中圖分類號]R782.12 ? ?[文獻標志碼]A ? ?[文章編號]1008-6455（2019）12-0132-04

Comparative Analysis of Aesthetic Effects of Immediate Implantation and Early Implant on Soft Tissue around Anterior Implant

DING Shan-shan

（Depaartment of Stomatology，the First Hospital of Kunshan，Kunshan 215300，Jiangsu，China）

Abstract： Objective To investigate the clinical effects of immediate implantation and early implantation and the esthetic value of soft tissue around the anterior implant. Methods A total of 72 patients with single maxillary anterior defects who were admitted to our hospital from March 2015 to June 2018 were enrolled. The patients were divided into immediate implantation group and early implantation group according to the random number table method， and 36 cases were in both groups. The Pink Esthetic Score （PES） and marginal bone resorption level at 1 month， 3 months， 6 months and 12 months after repair were compared between the two groups. The success rate and satisfaction of the two groups after 12 months of restoration were compared. Results At 1 month， 3 months， 6 months and 12 months after repair， the PES scores of the immediate implantation group were significantly higher than those of the early implantation group （P<0.05）; at 1 month， 3 months， and 12 months after surgery， the marginal bone resorption level of the immediate implantation group was not significantly different from that of the early planting group （P>0.05）， but immediate group after 6 months of restoration， the bone resorption level of the group was significantly lower than that of the early implant group （P<0.05）;the implantation success rate shows no significant difference between two groups.Whereas the satisfaction of patients of immediate group is significant higer than another group. Conclusion Compared with early implantation， immediate implantation can significantly improve the esthetic value of soft tissue in esthetic area. Both immediate and early implantation can get the satisfactory implant success . The immediate implant maybe works in reducing ?early bone resorption levels after implantation.however， the bone resorption in the late stage of repair was similar to that in the early stage.

Key words： immediate implant; early implant; esthetic value;aesthetic effect

口腔種植成功的標準已經由種植體留存率向種植體綜合成功率過渡[1]。上前牙美學區的牙缺失對患者的外貌、功能及心理影響較大，患者通常又有更高的綜合美學要求，因此，在前牙美學區如何最大程度地獲得理想的美學效果仍是臨床上面臨的一大挑戰[2]。早期種植是指在拔牙后4～16周內植入種植體，分為軟組織愈合和部分骨愈合的早期種植。即刻種植憑借其可縮短患者缺牙時間，減少患者二次手術的優勢，近年來受到廣泛關注[3-4]。有研究認為種植時機的不同對軟組織形態有一定影響[5]，既往研究多關于早期種植與即刻種植在種植成功率上的差異，鮮有關于兩者對前牙種植體周邊軟組織的美學價值綜合對比研究。本研究通過對72例筆者醫院收治的上頜前部單牙缺失患者進行分組對比，旨在比較即刻種植修復與早期種植修復的臨床效果及對前牙種植體周邊軟組織的美學效果，現將結果報道如下。……