上前牙伴唇侧骨壁缺损的即刻种植美学修复探究

发布时间：2018-11-09 17:34

【摘要】：目的:本课题旨在探讨在单颗上前牙唇侧骨壁缺损的情况下,以特定的手术方案进行即刻种植来重建唇侧骨壁,并行延期修复达到良好的种植美学修复效果的方法。研究对象与方法:选取2013年1月至2015年8月山东大学口腔医院符合纳入标准的成年患者17名,通过翻瓣手术、唇侧过量植骨并行GBR、胶原蛋白海绵辅助创口缝合的手术方法及延期修复进行种植修复,获得影像学及临床资料共计17例。收集术前、术后6月及复诊的CBCT(Galileos,Sirona Dental Systems)影像资料,以指定的测量方式对种植位点唇侧骨壁颈部(L1)、根中(L2)和根尖(L3)部位进行测量,获得唇侧骨壁变化的数据;同时收集临床数据,根据国内的种植体成功标准统计种植体存留率;并且拍摄修复后患者口内照片,用belser等人提出的粉红色美学评分PES标准和白色美学评分WES标准对修复进行美学评估;最后对上述数据进行统计分析。结果:1.唇侧骨壁的增量:所有患牙原唇侧骨壁颈部L1值均为0,根中部L2值为(0.65±0.65)mm,平均值为0.4mm,根尖部L3值为(1.1 土 1.1)mm,平均值为0.5mm;术后6月患牙唇侧骨壁获得重建,种植体颈部L1'的增量为(1.35±0.55)mm,平均值为1.3mm,中部L2的增量为为(2.6±1.2)mmm,平均值为2.1mm,根尖L3的增量为(3.45 土 2.65)mm,平均值为2.4mm;2.种植体存留率:所有种植位点的种植体存留率为100%,无患者在修复后出现并发症;3.美学评分:经过三名评估人员评估得到患牙修复后粉红色美学评分PES为(7.45±1.85)分,平均7.12分,白色美学评分WES的评分为(8.2±1.5)分,平均8.36分。结论:本研究中所通过翻瓣手术、唇侧过量植骨并行GBR、胶原蛋白海绵辅助创口缝合的手术方法及延期修复在上颌单颗前牙唇侧骨壁缺损的病例中能获得较高的种植体成功率,唇侧骨壁重建厚度理想,初期美学效果良好,长期效果仍待观察。
[Abstract]:Objective: to explore the method of reconstruction of labial bone wall by immediate implantation with a specific surgical scheme, and to achieve a good aesthetic effect of implant prosthesis under the condition of labial bone wall defect of a single anterior tooth. Subjects and methods: from January 2013 to August 2015, 17 adult patients who met the inclusion criteria in Stomatology Hospital of Shandong University were selected. Labial overgrafting and GBR, were performed through valvus surgery. The surgical method of collagen sponge assisted wound suture and the delayed repair of the wound were performed with implant repair. The imaging and clinical data were obtained in 17 cases. CBCT (Galileos,Sirona Dental Systems) images were collected before, 6 months after operation and after follow-up. The labial bone wall and neck (L1), middle root (L2) and root tip (L3) were measured at the implant site. The data of the changes of labial bone wall were obtained. At the same time, the clinical data were collected and the survival rate of implants was counted according to the domestic standards of implant success. After the restoration, the patients were photographed in the mouth and evaluated with the pink aesthetic score PES standard and the white aesthetic score WES standard proposed by belser et al. Finally, the above data were statistically analyzed. The result is 1: 1. The increment of the labial bone wall: the L1 value of the primary labial bone wall and neck of all affected teeth was 0, the L2 value of the middle root was (0.65 卤0.65) mm, the mean value of L3 in the root tip was (1.1 卤1.1) mm, the average value was 0.5 mm. Six months after operation, the labial bone wall was reconstructed. The increment of L1 'was (1.35 卤0.55) mm, and that of L2 was (2.6 卤1.2) mmm,. The increment of root tip L3 is (3.45 卤2.65) mm, average is 2.4 mm; 2. Implant retention rate: the implant retention rate of all implant sites was 100. No complications occurred in the patients after repair. 3. Aesthetic score: the pink aesthetic score (PES) was (7.45 卤1.85) (mean 7.12), the white aesthetic score (WES) was (8.2 卤1.5), and the average was 8.36 (P < 0.05). Conclusion: in this study, the method of overgrafting of labial bone with GBR, collagen sponge assisted suture and delayed repair of maxillary single anterior labial bone wall defect can obtain higher success rate of implants in this study. The thickness of labial bone wall reconstruction is ideal, the initial aesthetic effect is good, and the long-term effect remains to be observed.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.6

【相似文献】