目的 比较即刻种植与初期种植的种植体存留率与种植后5年边缘骨吸收的情况,为选择种植时机提供参考。方法 选择拔牙后即刻种植和拔牙后两周内行牙种植(初期种植)的患者58例,共计75颗种植体,其中初期种植的27颗植体为A组,即刻种植的48颗植体为B组,分别于术后即刻、1、3、6、12个月,以后每12个月拍摄X线片,随访5年及以上种植体存留情况,测量植体近远中牙槽嵴顶骨吸收的程度。用SPSS21.0统计软件,对寿命表法计算的两组成功率和存留率进行χ2检验,近远中骨吸收值进行两独立样本t检验。结果 A组种植体成功率79.25%,存留率100%;B组种植体在种植后1~9个月内5颗脱落,成功率76.47%,存留率89.47%,在种植体成功率方面,两者差异无统计学意义;在存留率方面,两者差异具有统计学意义。此外,术后即刻、随访5年近中牙槽嵴高度差值比较,A组为(1.16±0.32) mm,B组为(1.39±0.41) mm,P=0.216;远中牙槽嵴高度差值A组为(0.96±0.39) mm,B组为(1.05±0.52) mm,P=0.302;统计学分析显示,在种植术后5年,初期种植与即刻种植在近远中牙槽嵴改变值方面无统计学差异。结论 在拔牙窝愈合的初期(7~14 d)行种植体的植入,是可行的种植手术时机。
Abstract
Objective To investigate the survival rates of primary implantation and immediate implantation and marginal bone loss 5 years after implantation in order to provide reference for clinical implantation timing.Methods 58 cases involving 75 implants were selected in this study. According to the time of implant placement, 27 cases of implants were classified into Group A(initial implantation), and another 48 implants into Group B(immediate implantation). Patients had x-ray taken immediately after surgery,1,3,6,12 months later and eventually once a year.The survival rates of the implants were calculated and the mesial and distal alveolar marginal bone loss was measured. The two rates calculated with life table method and the amount of mesial and distalmarginal bone loss were determined using SPSS21.0 software withChi-squared testand independent samples t-test respectively.Results The success rate of Group A was 79.25%, and survival rate was 100%, compared with 76.47% and 89.47% in Group B, in which there was 5 implants loss during 1-9 months after implantation. Statistical analysis showed that there was significant difference in the survival rate only. Moreover, the difference value of the mesial alveolar bone between immediately after implantation and 5 years after implantation was 1.16±0.32 in Group A and 1.39±0.41 in Group B. P value was 0.216. The difference value of the distal alveolar bone between immediately after implantation and 5 years after implantation was 0.96±0.39 in Groups A, compared to 1.05±0.52 in Group B. P value was 0.302. Statistical analysis showed that there was no significant difference between thetwo groups.Conclusions Initial implantation is feasible.
关键词
初期种植 /
即刻种植 /
种植时机 /
存留率 /
边缘骨吸收
Key words
initial implantation /
immediate implantation /
the timing of implant /
survival rates /
marginal bone loss
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Chen S T,Wilson T G,Hämmerle C H. Immediate or early placement of implants following tooth extraction:review of biologic basis,clinical procedures,and outcomes[J].Int J Oral Maxillofac Implants,2004,19(1):12-25.
[2] Marius K,Ricardas K.The preservation of alveolar bone ridge during tooth extraction[J].Baltic Dent and Maxillofac Journal,2012,14(1):3-11.
[3] Misch C E,Perel M L,Wang H L, et al .Implant success,survival, and failure:the international Congress of Oral Implantologists(ICOI) Pisa Consensus Conference[J].Implant Dent,2008,17(1):5-15.
[4] Akiyoshi F,Maurice A,Tomohiro I, et al .Timing,positioning,and sequential staging in esthetic implant therapy:a four-dimensional prespective[J].Int J Periodontics Restorative Dent,2007,27(4):313-323.
[5] Schropp L, Isidor F. Timing of implant placement relative to tooth extraction[J]. J Oral Rehabil,2008,35(1):33-43.
[6] Buser D, Bornstein M M, Weber H P, et al . Early implantplacementwithsimultaneous guided boneregenerationfollowing single toothextraction in the esthetic zone: a cross-sectional, retrospective study in 45 patients with a 2-to4-year follow-up[J].J Periodontol,2008,79(9):1773-1781.
[7] Buser D, Chen S T, Weber H P.Early implant placement following single-tooth extraction in the esthetic zone: biologicrationale and surgical procedures[J]. Int J Periodontics Restorative Dent,2008,28(5):441-451.
[8] Chen S,Buser D.Implants in post-extractionsites: a literature update[M]. ITI TreatmentGuide, vol.3: Implants in extraction sockets.Berlin:Quintessence,2008.
[9] Schulte W, Heinke G. The Tubingen immediate implant[J]. Quintessenz, 1976,27(1):17-23.
[10] Koh R U,Rudek L,Wang H L.Immediate implant placement:positives and negtives[J]. Implant Dent,2010,19(2):98-108.
[11] Amler M H.The time sequence of tissue regeneration in human extraction wounds[J]. Oral Surg Oral Med Oral Pathol,1969,27(3):309-318.
[12] Lekovic V, Kenney E B, Weinlaender M. A bone regenerative approach to alveolar ridge maintenance following tooth extraction.Report of 10 cases[J]. J Periodontol, 1997,68(6):563-570.
[13] Lin W L.Differentiation of periodontal ligament broblasts into osteoblasts duringsocket healing after tooth extraction in the rat[J]. Anatatomical Records,1994,240(4):492-506.
[14] Cardaropoli G, Araújo M, Lindhe J. Dynamics of bone tissue formation in tooth extraction sites.An experimental study in dogs[J]. J Clin Periodontol,2003,30(9): 809-818.
[15] Lalani Z, Wong M, Brey E M. Spatial and Temporal Localization of FGF-2 and VEGF in Healing Tooth Extraction Sockets in a Rabbit Model[J]. J Oral Maxillofac Surg,2005,63(10):1500-1508.
[16] Lin Z, Rios H F, Volk S L. Gene Expression Dynamics During Bone Healing and Osseointegration[J]. Int J Oral ,2011,82(7):1007-1017.
[17] Chen S T, Buser D. Clinical and esthetic outcomes of implants placed in postextraction sites[J]. Int J Oral Maxillofac Implants,2009,24(1):186-217.
[18] Watzek G, Haider R, Mensdorff-Pouilly N. Immediate and delayed implantation for complete restoration of the jaw following extraction of all residual teeth: a retrospective study comparing different types of serial immediate implantation[J]. Int J Oral Maxillofac Implants,1995,10(5):561-567.
[19] Palattella P, Torsello F, Cordaro L. Two-year prospective clinical comparison of immediate replacement vs immediate restoration of single tooth in the esthetic zone[J].Clin OralImplants Res,2008,19(11):1148-1153.
[20] Anibali S, Bignozzi I, Iaccovazzi L, et al .Immediate,early and late implant placement in molarsites: a retrospective case series[J]. Int J Oral Maxillofac Implants,2011,26(5):1108-1122.
[21] Quirynen M, Van Assche N, Botticelli D, et al . How does the timing of implant placement to extraction affect outcome?[J].Int J Oral Maxillofac Implants, 2007,22(1):203-223.
[22] Schropp L, Wenzel A. Timing of single implant placement and long-term observation of marginal bone levels[J].Eur J Oral Implantol,2016,9(1):107-122.
[23] Kan J Y, Rungcharassaeng K, Liddelow G, et al .Periimplant tissue response following immediate provisional restoration of scalloped implants in the esthetic zone: a one-year pilot prospective multicenter study[J]. J Pros-thet Dent, 2007,97(6):109-118.
[24] Polizzi G, Grunder U, Goene R, et al . Immediate and delayed implant placement into extraction sockets:a 5-year report[J].Clin Implant Dent Relat Res, 2000,2(2):93-99.
[25] Soydan S S, Cubuk S, Oguz Y, et al . Are success and survival rates of early implant placement higher than immediate implant placement?[J].Int J Oral Maxillofac Surg, 2013,42(4):511-515.
[26] Chen S T, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla-A systematic review[J].Int J Oral Maxillofac Implants,2014,29(1):186-215.
PDF(1754 KB)
