美学区单颗牙即刻种植即刻与延期修复美学效果的临床研究

发布时间：2018-07-27 10:53

【摘要】：目的通过临床病例研究，对上颌美学区单颗牙即刻种植后即刻修复与延期修复的美学治疗效果进行初步的观察和分析，探讨临时修复时机的选择对最终修复的美学效果是否有显著的影响。方法对20例上颌前牙单颗牙缺失的患者即刻植入种植体，实验组为即刻修复组共9例，于手术后戴入种植体支持式临时冠，3~4个月后进行永久冠修复；对照组为进行临时冠牙龈塑形的延期修复组共11例，于手术后戴入马里兰桥，3~4个月后行二期手术，，并戴入种植体支持式临时冠进行牙龈塑形，约2个月后行永久冠修复。采用种植体成功率、红色美学评分（pink esthetic score，PES）和患者的满意度对治疗效果进行评价。结果种植体成功率为95%，有1例在永久修复4个月后，唇侧出现瘘管，种植体近中出现约2mm的骨吸收。红色美学方面实验组PES总分均值为8.50±1.20，对照组PES总分均值为8.23±0.97，两组之间的差别无统计学意义（P0.05）；无论是实验组还是对照组，修复3个月后的美学分值（实验组8.78±1.20，对照组8.64±0.92）要高于修复后当天的分值（实验组8.22±1.20，对照组7.82±0.87），并且之间的差别有统计学意义（P0.05）；其中牙龈近远中龈乳头的分值是最低的，其次是唇侧牙龈高度，唇侧牙龈曲线及牙根部突度、牙龈色质的美学分值最高。满意度方面，实验组患者对治疗效果和治疗过程的满意率分别为88.89%和100%，对照组为81.82%和63.64%。结论即刻种植后采用临时冠对牙龈进行保存或重建都能取得较为理想的美学治疗效果；即刻修复比临时冠牙龈塑形的延期修复的美学治疗效果要更好，但两者之间的差别无统计学意义；修复3个月后的美学效果要好于修复后当天，并且两者之间的差别有统计学意义；即刻修复的患者对治疗效果和治疗过程的满意率要高于延期修复者，但差别无统计学意义。
[Abstract]:Objective to observe and analyze the aesthetic effect of immediate and delayed restoration of a single tooth in maxillary aesthetic area by clinical case study. To explore whether the choice of temporary repair timing has a significant impact on the aesthetic effect of final restoration. Methods 20 cases of maxillary anterior teeth with a single missing tooth were immediately implanted with implants. The experimental group (n = 9) was treated with implant-supported temporary crown for 3 ~ 4 months. In the control group, 11 cases were treated with delayed restoration of temporary crown gingival shape. The patients were put into Maryland Bridge 3 ~ 4 months after operation for second stage operation, and implant supported temporary crown for gingival reconstruction, about 2 months later for permanent crown restoration. Implant success rate, red aesthetic score (pink esthetic scorepes) and patient satisfaction were used to evaluate the therapeutic effect. Results the success rate of implant was 95%. After permanent repair for 4 months, fistula appeared on the labial side and bone resorption of 2mm was found in the proximal implant. In terms of red aesthetics, the average value of PES in the experimental group was 8.50 卤1.20, and that in the control group was 8.23 卤0.97.The difference between the two groups was not statistically significant (P0.05), no matter in the experimental group or in the control group, there was no significant difference between the two groups (P0.05). The aesthetic scores of the experimental group (8.78 卤1.20) and the control group (8.64 卤0.92) were significantly higher than those of the control group (8.22 卤1.20) and the control group (7.82 卤0.87) (P0.05). The second is the height of the labial gingiva, the curve of the labial gingiva and the protruding degree of the root, and the aesthetic score of the color quality of the gingiva is the highest. The satisfaction rates of the patients in the experimental group were 88.89% and 100, respectively, and those in the control group were 81.82% and 63.64%, respectively. Conclusion the effect of immediate restoration with temporary crown on gingival preservation or reconstruction is better than that of delayed restoration of gingival shape with temporary crown, and the effect of immediate restoration is better than that of delayed restoration of gingival shape with temporary crown, and the effect of immediate restoration is better than that of delayed restoration of gingival shape with temporary crown. But the difference between the two is not statistically significant, the aesthetic effect after 3 months of restoration is better than that of the day after restoration, and the difference between the two is statistically significant. Patients with immediate repair were more satisfied with the efficacy and course of treatment than those with delayed repair, but the difference was not statistically significant.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6

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