因牙周炎缺失上前牙种植修复后短期软组织美学效果评价

发布时间：2018-11-06 08:59

【摘要】：目的:评价因牙周炎缺失上前牙种植修复后的短期软组织美学效果。方法:选择因牙周炎需拔除上前牙的患者15人,共涉及牙齿20颗,患牙两侧有天然牙,所有患者均已接受系统牙周治疗。拔牙后自然愈合2~3个月,采用常规翻瓣种植手术植入种植体,术中记录牙槽骨缺损的程度、种植体植入深度(种植体距离邻牙釉牙骨质界连线的距离)等指标,采用埋入愈合方式。愈合3个月后行二期手术并完成修复。修复后1~3个月复查,用红色美学评分(pink esthetic score,PES)评价软组织美学效果。结果:所有种植体均成功达到骨结合,没有早期种植体松动脱落发生。因牙周炎缺失的上前牙经种植修复后,PES均值为(9.6±2.4)分(5~13分),其中3颗修复体的PES低于7分。仅有水平骨缺损的13个位点种植修复后的PES均值为(10.5±1.9)分,显著高于伴有垂直向骨缺损的7个位点[(7.9±2.3)分,P0.05]。PES与种植体植入深度呈负相关关系(r=-0.608,P0.01)。结论:因牙周炎导致的前牙缺失存在较高的种植美学风险,牙槽骨缺损尤其是垂直骨缺损的程度和部位是影响软组织美学效果的主要因素。
[Abstract]:Objective: to evaluate the short-term aesthetic effect of anterior teeth implant repair due to periodontitis. Methods: 15 patients with periodontitis were selected, 20 teeth were involved, and natural teeth were found on both sides of the teeth. All the patients were treated with systemic periodontal therapy. After 2 ~ 3 months of natural healing, the implant was implanted by conventional flap implantation. The extent of alveolar bone defect and the depth of implant implantation (the distance between implant and enamel bone line) were recorded during the operation. The method of embedding healing was adopted. After 3 months of healing, the second stage operation was performed and the repair was completed. The aesthetic effect of soft tissue was evaluated with red aesthetic score (pink esthetic score,PES) 1 ~ 3 months after repair. Results: all implants succeeded in bone bonding, and no early loosening and exfoliation of implants occurred. The mean PES of anterior teeth with periodontitis was (9.6 卤2.4) (5 ~ 13), and the PES of 3 prostheses was lower than 7. The mean PES of 13 sites with only horizontal bone defect was (10.5 卤1.9), which was significantly higher than that of 7 sites with vertical bone defect [(7.9 卤2.3)]. There was a negative correlation between PES and implant depth (r = -0.608, P 0.01). Conclusion: there is a high risk of implant aesthetics in anterior tooth defect caused by periodontitis. The extent and location of alveolar bone defect, especially vertical bone defect, are the main factors influencing the aesthetic effect of soft tissue.
【作者单位】：北京大学口腔医学院·口腔医院牙周科;
【基金】：卫生部临床重点专科项目曹采方耕耘基金(2010)资助~~
【分类号】：R783.6

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