摘要
目的探讨口腔锥形束CT(CBCT)动态监测双尖牙区即刻种植和位点保存延期种植对牙槽骨高度、宽度、周围骨密度影响,以期为临床制定后续干预方案提供参考。方法前瞻性选取2020年4月至2022年4月于郑州大学第一附属医院口腔科就诊的62例双尖牙区需拔除并行种植修复患者作为研究对象,按随机数表法分为即刻种植组和位点保存延期种植组各31例,两组患者均于种植治疗前、种植体植入6个月后行CBCT扫描,比较两组患者的牙槽骨高度丧失量(H值)、宽度丧失量(W值)、周围骨密度(T值)、红色美学指数(PES)评分和炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平,并比较两组患者的主观满意度和并发症发生情况。结果位点保存延期种植组植入6个月后牙槽骨H值、W值分别为(1.62±0.28)mm、(0.36±0.09)mm,高于即刻种植组的(0.79±0.17)mm、(0.14±0.05)mm,T值为(135.27±7.54)HU,低于即刻种植组的(188.35±9.36)HU,差异均有统计学意义(P<0.05);位点保存延期种植组植入6个月后牙龈色质、唇侧牙龈高度、唇侧牙龈曲线、远中龈乳头、中龈乳头及总分分别为(1.13±0.19)分、(1.52±0.31)分、(1.62±0.28)分、(1.28±0.18)分、(1.35±0.14)分、(6.90±1.35)分,低于即刻种植组的(1.79±0.28)分、(1.97±0.38)分、(1.92±0.35)分、(1.81±0.24)分、(1.87±0.18)分、(9.36±1.68)分,差异均有统计学意义(P<0.05);位点保存延期种植组修复后30 d的血清CRP、TNF-α水平分别为(2.12±0.36)mg/L、(5.74±0.58)ng/mL,明显高于即刻种植组修复后30 d的(1.45±0.24)mg/L、(4.22±0.48)ng/mL,差异均有统计学意义(P<0.05);位点保存延期种植组患者的附着高度、美观度、咀嚼功能评分分别为(6.38±1.45)分、(7.31±1.54)分、(6.72±1.41)分,低于即刻种植组的(8.58±1.72)分、(8.98±1.76)分、(8.85±1.58)分,差异均有统计学意义(P<0.05);即刻种植组患者的并发症总发生率为16.13%,略低于位点保存延期种植组的19.35%,但差异无统计学意义(P>0.05)。结论口腔CBCT可用于评估即刻种植和延期种植对双尖牙区牙槽骨高度、宽度、周围骨密度的影响,即刻种植可提高口腔美观度,改善炎症状态,且安全性良好。
Objective To investigate the effect of immediate and site-preserved delayed implantation on the height,width,and peripheral bone mineral density(BMD)of the bicuspid region by dynamic monitoring with conical beam CT(CBCT),in order to provide reference for the development of subsequent intervention plans in clinical practice.Methods A prospective study was conducted on 62 patients who underwent extraction and implantation in the bicuspid region in the Department of Stomatology at the First Affiliated Hospital of Zhengzhou University from April 2020 to April 2022.The patients were randomly divided into an immediate implantation group and a site-preserved delayed implantation group,with 31 cases in each group.Both groups of patients underwent CBCT scanning before treatment and at 6 months after implantation.The height loss(H value),width loss(W value),peripheral bone density(T value),pink aesthetic index(PES)score,and inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]levels were compared between the two groups.The subjective satisfaction and complications were also compared.Results The H and W values of the alveolar bone after 6 months of implantation in the site-preserved delayed implantation group were(1.62±0.28)mm,(0.36±0.09)mm,which were significantly higher than(0.79±0.17)mm,(0.14±0.05)mm in the immediate implantation group;the T value was(135.27±7.54)HU,which were significantly lower than(188.35±9.36HU)in the immediate implantation group;the differences were statistically significant(P<0.05).The gingival color,lip side gingival height,lip side gingival curve,distal papilla,middle papilla,and total score at 6 months after implantation in the site-preserved delayed implantation group were(1.13±0.19)points,(1.52±0.31)points,(1.62±0.28)points,(1.28±0.18)points,(1.35±0.14)points,(6.90±1.35)points,which were significantly lower than(1.79±0.28)points,(1.97±0.38)points,(1.92±0.35)points,(1.81±0.24)points,(1.87±0.18)points,(9.36±1.68)points in the immediate implantation group(P<0.05).The serum CRP and TNF-αlevels in the site-preserved delayed implantation group at 30 days after implantation were(2.12±0.36)mg/L,(5.74±0.58)ng/mL,which were significantly higher than(1.45±0.24)mg/L,(4.22±0.48)ng/mL in the immediate implantation group(P<0.05).The attachment height,aesthetic score,and chewing function score in the site-preserved delayed implantation group were(6.38±1.45)points,(7.31±1.54)points,(6.72±1.41)points,which were significantly lower than(8.58±1.72)points,(8.98±1.76)points,(8.85±1.58)points in the immediate implantation group(P<0.05).The total incidence of complications in the immediate implantation group was 16.13%,which was slightly lower than 19.35%in the site-preserved delayed implantation group(P>0.05).Conclusion CBCT can be used to evaluate the impact of immediate and delayed implantation on the height,width,and peripheral bone density of the bicuspid region.Immediate implantation can improve oral aesthetics and inflammatory state,with good safety.
作者
牛方
吴宁
闫玉娟
朱娟芳
NIU Fang;WU Ning;YAN Yu-juan;ZHU Juan-fang(Department of Stomatology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第3期349-353,共5页
Hainan Medical Journal
基金
河南省重点研发与推广专项(编号:202102310075)。
关键词
口腔锥形束CT
双尖牙区
即刻种植
延期种植
牙槽骨高度
周围骨密度
Oral conical beam CT
Bicuspid region
Immediate implantation
Delayed implantation
Alveolar bone height
Peripheral bone density
