后牙即刻种植与延期种植回顾性临床研究

发布时间：2018-03-19 06:22

  本文选题：即刻种植　切入点：后牙区　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景:牙体缺损及牙列缺损是口腔医学的常见病和多发病,在世界范围内有较高的患病率。后牙区牙体缺损或牙列缺损最直接的影响就是咀嚼困难。如何缩短缺牙时间,早期修复,进行微创治疗,已经成为学者们关注的问题。不翻瓣即刻种植是指微创拔除无法保留的残根或残冠后,将种植体同期植入的方法。即刻种植技术突破了经典的骨结合理论,不再需要经过6个月的骨愈合期,拔牙创口愈合与种植体骨结合同期完成,大大缩短临床治疗时间,减少了种植体周围骨组织及软组织的吸收。目前不翻瓣即刻种植大量文献研究主要集中在前牙区,针对后牙区的研究相对较少。后牙多为多根牙,拔牙窝形态与种植体形状不匹配,初期稳定性获得较困难[1]。而且后牙区拔牙创口大,初期软组织关闭比较困难。这些问题使得后牙区即刻种植受到限制[2],因此解决好后牙区即刻种植技术的难点,将会更好地造福于患者。目的:本研究通过对比即刻种植和延期种植种植体植入后6个月、12个月、24个月种植体周围边缘骨量的变化,以及三种不同的种植体系统在后牙即刻种植中,术后6个月、12个月、24个月种植体周围边缘骨量的变化。探讨即刻种植和延期种植种植体周围骨组织变化的差异,不同种植体系统的选择对即刻种植种植体周围骨量的影响。从而为后牙区即刻种植技术的临床效果和远期成功率提供客观的参考依据。方法:选择2012年1月至2013年12月就诊于吉林大学口腔医院种植科在后牙区进行种植治疗的52例患者,共植入种植体52枚。其中即刻种植26例,延期种植26例。种植体植入后3-6个月行永久修复。分别于术后当天、术后6个月、12个月、24个月进行影像学测量检查,测量种植体周围边缘骨高度的变化。结果:1.术后6个月与术后当天相比:即刻种植组近中边缘骨增量为1.35±1.12mm,延期种植组近中边缘骨增量为-0.52±0.47mm;两组相比P0.05,差异没有统计学意义。2.术后6个月与术后当天相比:即刻种植组远中边缘骨增量为1.46±1.17mm,延期种植组远中边缘骨增量为-0.46±0.44mm;两组相比P0.05,差异没有统计学意义。3.术后12个月与术后当天相比:即刻种植组近中边缘骨增量为2.16±1.73mm,延期种植组近中边缘骨增量为-0.69±0.58mm;两组相比P0.05,差异没有统计学意义。4.术后12个月与术后当天相比:即刻种植组远中边缘骨增量为1.94±1.16mm,延期种植组远中边缘骨增量为-0.60±0.45mm;两组相比P0.05,差异没有统计学意义。5.术后24个月与术后当天相比:即刻种植组近中边缘骨增量为2.53±1.65mm,延期种植组近中边缘骨增量为-0.97±0.78mm;两组相比P0.05,差异没有统计学意义。6.术后24个月与术后当天相比:即刻种植组远中边缘骨增量为2.32±1.68mm,延期种植组远中边缘骨增量为-0.72±0.63mm;两组相比P0.05,差异没有统计学意义。7.即刻种植组术后6个月与术后当天相比近中边缘骨增量为1.35±1.12mm,术后12个月与术后当天相比近中边缘骨增量为2.16±1.73mm,两组相比P0.05,差异具有统计学意义。8.即刻种植组术后6个月与术后当天相比近中边缘骨增量为1.35±1.12mm,术后24个月与术后当天相比近中边缘骨增量为2.53±1.65mm,两组相比P0.05,差异具有统计学意义。9.即刻种植组术后24个月与术后当天相比近中边缘骨增量为2.53±1.65mm,术后12个月与术后当天相比近中边缘骨增量为2.16±1.73mm,两组相比P0.05,差异没有统计学意义。10.即刻种植组术后6个月与术后当天相比远中边缘骨增量为1.46±1.17mm,术后12个月与术后当天相比远中边缘骨增量为1.94±1.16mm,两组相比P0.05,差异具有统计学意义。11.即刻种植组术后6个月与术后当天相比远中边缘骨增量为1.46±1.17mm,术后24个月与术后当天相比远中边缘骨增量为2.32±1.68mm,两组相比P0.05,差异具有统计学意义。12.即刻种植组术后24个月与术后当天相比远中边缘骨增量为2.32±1.68mm,术后12个月与术后当天相比远中边缘骨增量为1.94±1.16mm,两组相比P0.05,差异没有统计学意义。13.即刻种植组在种植体植入后6个月Straumann种植体近远中边缘骨增加量与Biomet 3i种植体相比,Straumann种植体近远中边缘骨增加量与Nobel Replace种植体相比,Biomet 3i种植体近远中边缘骨增加量与Nobel Replace种植体相比,3种种植体的近远中边缘骨增加量均无明显差异(P0.05)。14.即刻种植组在种植体植入后12个月Straumann种植体近远中边缘骨增加量与Biomet 3i种植体相比,Straumann种植体近远中边缘骨增加量与Nobel Replace种植体相比,Biomet 3i种植体近远中边缘骨增加量与Nobel Replace种植体相比,3种种植体的近远中边缘骨增加量均无明显差异(P0.05)。15.即刻种植组在种植体植入后24个月Straumann种植体近中边缘骨增加量明显高于Biomet 3i种植体,差异有统计学意义(P0.05)。Straumann种植体近中边缘骨增加量高于Nobel Replace种植体,差异有统计学意义(P0.05)。Biomet 3i种植体近中边缘骨增加量与Nobel Replace种植体相比,2种种植体的近远中边缘骨增加量均无明显差异(P0.05)。16.即刻种植组在种植体植入后24个月Straumann种植体远中边缘骨增加量与Biomet 3i种植体相比,Straumann种植体远中边缘骨增加量与Nobel Replace种植体相比,Biomet 3i种植体远中边缘骨增加量与Nobel Replace种植体相比,3种种植体的近远中边缘骨增加量均无明显差异(P0.05)。结论:1.即刻种植边缘骨2年内呈增长趋势,6个月增加最多,12个月后基本稳定。延期种植边缘骨2年内呈吸收趋势,6个月内吸收最多,12个月后基本稳定。2.不同种植系统可能对即刻种植边缘骨组织产生影响。3.即刻种植与延期种植短期内具有相似的成功率和临床效果。
[Abstract]:Background: tooth defect and dentition defect of oral medicine is common and frequently occurring disease in the world, with a higher prevalence. Effect of posterior area of tooth defect or dentition defect is the most direct chewing difficulties. How to shorten the time of tooth loss, early repair, minimally invasive treatment, has become a scholar focus. Flapless immediate implant is a minimally invasive extraction can not keep the residual roots or crowns after implant placement methods. Immediate implant technology breaks through the classical bone binding theory, no longer need to go through 6 months of bone healing, wound healing and osseointegration period, shorten treatment time, reduce the peri implant bone and soft tissue absorption. The flapless immediate implant literature research mainly concentrated in the anterior region, the posterior region is relatively small. After multiple Root tooth, tooth nest shape and implant shape does not match the initial stability is difficult to obtain [1]. and posterior tooth extraction wound, early closure of soft tissue is difficult. These problems make the posterior area of immediate implant is limited to [2], therefore solve the technical difficulties of immediate implants in the posterior area, will be better for the benefit of patients. Objective: 6 months after the comparison of immediate implant and delayed implant implant after 12 months, 24 months of peri implant marginal bone mass, and three different implant systems in the teeth after immediate implantation, 6 months after surgery, 12 months, 24 months of implant edge to investigate the difference of bone mass. Immediate implantation and delayed implant bone around the implant changes, different implant systems choose implant effect of peri implant bone for immediate clinical effect. So as to the posterior area of immediate implant technology The fruit and the long-term success rate provides objective basis. Methods: 52 cases from January 2012 to December 2013 in planting Department of Stomatological Hospital of Jilin University in the posterior area to plant patients treated with implants were implanted in 52 cases. The immediate implant in 26 cases, 26 cases of delayed implant. 3-6 months for permanent repair implant. On the day after surgery, 6 months after surgery, 12 months, 24 months of radiographic measurement inspection, measuring body around the marginal bone height changes. Results: 1. implant 6 months after operation and postoperative day compared with immediate implant group near the edge of bone increment was 1.35 + 1.12mm, extension the marginal bone planting group for -0.52 + 0.47mm increment of nearly two; group P0.05, the difference was not statistically significant.2. 6 months after surgery and postoperative day: immediate implant group compared to distal marginal bone increment was 1.46 + 1.17mm group, delayed implant distal marginal bone in increments of -0.46 + 0.44mm; Two group P0.05, the difference was not statistically significant.3. 12 months after surgery and postoperative day compared with immediate implant marginal bone in group increment was 2.16 + 1.73mm, delayed implant marginal bone group was -0.69 + 0.58mm increment in two groups; compared to P0.05, the difference was not statistically significant.4. 12 months after surgery and surgery the day after the immediate implant group compared: distal marginal bone increment was 1.94 + 1.16mm group, delayed implant distal marginal bone in increments of -0.60 + 0.45mm; two group P0.05, the difference was not statistically significant.5. 24 months after surgery and postoperative day compared with immediate implant marginal bone in group increment was 2.53 + 1.65mm. Delayed implant marginal bone group was -0.97 + 0.78mm increment in two groups; compared to P0.05, the difference was not statistically significant.6. 24 months after surgery and postoperative day: immediate implant group compared to distal marginal bone increment was 2.32 + 1.68mm group, delayed implant distal marginal bone in increments of -0.72. 0.63mm; two group P0.05, the difference was not statistically significant.7. immediate implant group 6 months after operation and postoperative day compared to the marginal bone near the incremental was 1.35 + 1.12mm, 12 months after surgery and postoperative day compared to the marginal bone near the incremental was 2.16 + 1.73mm, two group P0.05, the difference was statistically significant.8. immediate implant group 6 months after operation and postoperative day compared to the marginal bone near the incremental was 1.35 + 1.12mm, 24 months after surgery and postoperative day compared to the marginal bone near the incremental was 2.53 + 1.65mm, two group P0.05, the difference was statistically significant.9. immediate implant group 24 months after operation and operation the day after the bone near the edge compared to increment was 2.53 + 1.65mm, 12 months after surgery and postoperative day compared to the marginal bone near the incremental was 2.16 + 1.73mm, two group P0.05, the difference was not statistically significant.10. immediate implant group 6 months after operation and postoperative day compared to 1 in the far edge of bone augmentation .46 + 1.17mm, 12 months after surgery and postoperative day compared to distal marginal bone increment was 1.94 + 1.16mm, two group P0.05, the difference was statistically significant.11. immediate implant group 6 months after operation and postoperative day compared to distal marginal bone increment was 1.46 + 1.17mm, 24 months after surgery and surgery when days of distal marginal bone increment was 2.32 + 1.68mm, two group P0.05, the difference was statistically significant.12. immediate implant group 24 months after operation and postoperative day compared to distal marginal bone increment was 2.32 + 1.68mm, 12 months after surgery and postoperative day compared to 1.94 in the far edge of bone augmentation two + 1.16mm, compared to P0.05 group, the difference was not statistically significant.13. immediate implant implant in group Straumann after 6 months of implant in the near and far edge of bone increased with Biomet 3I implants compared to Straumann implants in the near and far edge of bone increased with Nobel Replace implants compared to Biomet 3 i绉嶆�嶄綋杩戣繙涓�杈圭紭楠ㄥ�炲姞閲忎笌Nobel Replace绉嶆�嶄綋鐩告�，

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