埋入式和非埋入式种植体对于薄龈型患者后牙区单颗固定种植修复后的影响

摘要

目的 探讨两段式埋入式种植体和非埋入式种植体对于薄龈型患者后牙区单颗固定种植修复后的影响.方法 选择口腔科就诊的口腔后牙单颗固定种植患者24例,牙龈厚度小于1.5 mm,排除种植禁忌证,通过编号并抽签的方法将患者随机分为2组各12例,分别应用奥齿泰SS和TS种植体,SS组采用非埋入式方式,而TS组则采用两段式埋入式方式,分别于种植术前、TS组二期手术前、上部结构修复后即刻、上部结构修复后1年观察牙龈厚度、Jemt龈乳头和边缘骨吸收的变化.结果 2组种植体在植入至负重1年后,所有种植体均无松动、炎症以及颈部骨吸收超过2 mm,成功率为100.0%.SS组牙龈厚度随时间延长逐渐减小,TS组呈现先增高后降低的趋势,2组牙龈厚度组间、时点间、组间·时点间交互作用差异均无统计学意义(P>0.05).2组间Jemt牙龈乳头指数在修复后即刻及修复后1年差异均无统计学意义(P>0.05),TS组内修复后即刻与修复后1年差异有统计学意义(P<0.05),而SS组内差异无统计学意义(P>0.05).2组种植体负重后颈部骨吸收量逐渐增加,时点间与组间·时点间交互作用差异有统计学意义(P<0.05),而组间差异无统计学意义(P>0.05).结论 2种手术方案对于薄龈型患者的牙龈厚度和Jemt龈乳头指数影响不大,SS组和TS组种植体颈部边缘骨吸收量均随着时间延长而增加,但两组间差异并无统计学意义.在正确选择适应证的情况下,后牙区单颗固定种植可根据患者具体情况选择合适的种植手术方式.%Objective To observe the difference of submerged and non-submerged dental implants on patients missing one molar with thin gingival.Methods Twenty-four patients in our department who had no contraindication of dental implants and missed one molar with less than 1.5 mm gingival were chosed and separated into 2 random groups with the method of numbers and draw.Patients of one group were implanted with non-submerged SS implants of OSSTEM and patients of another group were implanted with submerged TS implants of OSSTEM.At the time of implant surgery, second stage surgery, restoration finish and 1 year later, variance of gingival thickness,Jemt index and crestal bone loss were observed.Results All implants of 2 groups were successful with the 100.0%, without looseness and inflammation and crestalbone lost above 2mm.Gingival thickness of SS group was decreased, but that of the TS group was increased first and then decreased.There was no statistic difference between 2 groups about gingival thickness at the different time(P>0.05).There was no statistic difference between 2 groups about Jemt index of gingival papilla after restoration and 1years later(P>0.05),but there was statistic difference in the TS groups with different time(P<0.05).Volume of crestal bone loss in two groups both were increased as time went by.There was no statistic difference between 2 groups(P>0.05), but there was statistic difference between 2 groups about time and interaction with time and groups(P<0.05).Conclusion There is no influence of two surgical methods on variation of gingival thickness and Jemt index.Volume of crestal bone loss between the SS group and the TS group both increased.We would like to choose correct implants tothe patients missing one molar withcorresponding indication.