骨劈开联合GBR技术同期种植的短期临床效果观察

发布时间：2019-06-26 13:20

【摘要】：目的:牙槽嵴骨劈开技术是解决牙槽骨水平骨量不足情况下种植治疗的有效方法,本课题的目的是为了研究在牙槽骨垂直骨量充足但是水平骨量不足情况下,运用超声骨刀与手动骨劈开器进行骨劈开联合GBR技术进行口腔种植后,种植体稳定性,种植位点骨宽度变化量以及修复后红色美学,患者满意程度等临床问题,评价超声骨刀与手动骨劈开器进行骨劈开联合GBR技术在牙槽骨水平宽度不足情况下进行种植修复治疗的临床效果。方法:本研究按照纳入/排除标准,收集并整理缺牙区牙槽骨垂直骨量足够但水平骨量不足的种植修复治疗的患者资料,共34名。所有患者均采用超声骨刀与手动骨劈开器进行骨劈开联合GBR的口腔种植技术,并且同期植入种植体,共34枚。术后6个月行种植二期手术,置换愈合基台进行牙龈成形,两周后制取硅橡胶模型进行冠部修复,嘱患者填写满意程度调查表。通过比较术中和术后6个月种植体稳定性及种植位点骨宽度增加量,修复后和行使功能6个月后的红色美学评分,患者满意程度等临床参数,评价术后临床效果。结果:本课题共纳入患者34名,其中一名患者于术中发生唇侧骨板骨折,其数据排出统计。33名患者平均年龄51.82±9.40岁,所有患者种植体骨结合良好,均完成了上部结构修复,成功率100%。1.种植治疗患者种植体稳定性系数在术中和术后6个月时分别为:48.94±3.77和70.27±3.55,差异具有统计学意义(p0.01)。2.种植治疗患者缺牙位点术前,术后6个月水平骨量分别为:3.47±0.23 mm和4.72±0.22 mm,二者具有统计学差异(p0.01)。3.种植体上部修复体修复完成后和修复体使用6个月后的红色美学评分分别为:7.76±1.19和9.69±2.17,二者具有统计学差异(p0.01)。4.患者对种植修复治疗的总体满意程度跟修复完成后修复体的咀嚼功能,异物感程度,美观性,以及治疗花费具有相关性,修复体的异物感和舒适程度也具有相关性(p0.05)。满意程度调查表里面的各项指标跟术后红色美学评分均没有相关性(p0.05)。结论:超声骨刀与手动骨劈开器联合GBR技术扩大了种植治疗的相对适应症,对缺牙区域水平骨量不足情况下的种植治疗,术后骨量和牙周软组织美学方面评价均具有良好的临床效果,患者对于种植修复治疗的满意程度也较高。
[Abstract]:Objective: alveolar crest bone split technique is an effective method to solve the problem of alveolar bone horizontal bone mass insufficiency. The purpose of this paper is to study the stability of implantation body, the change of bone width at implantation site and red aesthetics after oral implantation with ultrasonic bone knife and manual bone splitter combined with GBR technique under the condition of sufficient vertical bone mass but insufficient horizontal bone mass of alveolar bone. To evaluate the clinical effect of ultrasonic bone knife and manual bone splitter combined with GBR in the treatment of alveolar bone with insufficient horizontal width of alveolar bone. Methods: according to the inclusion / exclusion criteria, the data of 34 patients with sufficient vertical bone mass but insufficient horizontal bone mass in alveolar bone were collected and sorted out. All patients were treated with ultrasonic bone knife and manual bone splitter for oral implantation of bone split combined with GBR, and 34 implants were implanted at the same time. Six months after operation, the secondary implantation operation was performed, and the gums were formed with the replacement healing platform. Two weeks later, the silicone rubber model was made for crown repair, and the patients were told to fill out the satisfaction questionnaire. The clinical effects were evaluated by comparing the stability of the implantation during and 6 months after operation, the increase of bone width at the implantation site, the red aesthetic score after repair and the exercise of function for 6 months, and the satisfaction of the patients. Results: a total of 34 patients were included in this study. One of them had labial plate fracture during operation, and the data were counted. The average age of 33 patients was 51.82 卤9.40 years old. All the patients had good bone union and completed the repair of superstructure with a success rate of 100%. The stability coefficient of implantation in patients treated with implantation was 48.94 卤3.77 and 70.27 卤3.55 during operation and 6 months after operation, the difference was statistically significant (p0.01). Before and 6 months after operation, the bone mass was 3.47 卤0.23 mm and 4.72 卤0.22 mm, respectively, and there was significant difference between the two groups (p0.01). The red aesthetic scores were 7.76 卤1.19 and 9.69 卤2.17 after the restoration was completed and 6 months after the restoration was used, respectively, and there was significant difference between the two groups (p0.01). 4 months after the restoration was completed and 6 months after the restoration was used, the red aesthetic scores were 7.76 卤1.19 and 9.69 卤2.17, respectively. There was a correlation between the overall satisfaction of the patients and the masticatory function, the degree of foreign body perception, aesthetics, and the cost of treatment, as well as the foreign feeling and comfort of the restoration body after the restoration was completed (p0.05), and there was a correlation between the overall satisfaction of the patients and the masticatory function, the degree of foreign body perception, the aesthetic degree and the cost of treatment. There was no correlation between the indexes in the satisfaction questionnaire and the postoperative red aesthetic score (p0.05). Conclusion: ultrasonic bone knife combined with manual bone splitter combined with GBR technique can expand the relative indication of implantation therapy, and has good clinical effect on bone mass and periodontal soft tissue aesthetics in the case of insufficient bone mass in missing tooth area, and the patients are satisfied with the treatment of implantation and repair.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.6

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