上海口腔医学

上海口腔医学 ›› 2020, Vol. 29 ›› Issue (3): 287-292.doi: 10.19439/j.sjos.2020.03.011

• 论著 • 上一篇    下一篇

牙后不同时机植入种植体的远期效果评价

李兖1, 白石2, 蒋丽兰1, 谭迎赟2   

  1. 1.重庆市北碚区中医院 口腔科,重庆 400700;
    2.重庆医科大学附属口腔医院 种植科,重庆 401147
  • 收稿日期:2019-08-08 修回日期:2019-09-16 出版日期:2020-06-25 发布日期:2020-07-29
  • 通讯作者: 谭迎赟,E-mail：500308@cqmu.edu.cn
  • 作者简介:李兖(1980-),男,本科,副主任医师,E-mail：molongliugang@163.com
  • 基金资助:
    重庆市自然科学基金 (2011jjA10086)

Long-term outcomes of dental implants at different times after tooth extraction

LI Yan1, BAI Shi2, JIANG Li-lan1, TAN Ying-yun2   

  1. 1. Department of Stomatology, Beibei Traditional Chinese Medical Hospital. Chongqing 400700;
    2. Department of Implantation, Stomatological Hospital of Chongqing Medical University. Chongqing 401147, China
  • Received:2019-08-08 Revised:2019-09-16 Online:2020-06-25 Published:2020-07-29

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摘要： 目的 探讨拔牙后患者单牙种植体早期、延期和晚期植入颌骨后8年锥形束CT（cone-beam CT,CBCT）数据,分析不同时机植入对种植体的影响,为选择拔牙后种植体合适植入时机提供参考。方法 回顾分析2010年1月—2010年12月重庆市北碚区中医院行拔牙术后单牙种植体植入的68例患者的临床资料,根据植入时间不同分为A、B、C 3组,早期植入（拔牙后7 d内）25例为A组、延期植入（拔牙后平均3个月）24例为B组、晚期植入（拔牙后平均1.5年）19例为C组。术后随访8年,比较CBCT图像和前后位（PA）图像显示的周围骨水平及与颌骨缺损的关系。采用SPSS 18.0软件包进行统计学分析。结果 共植入162颗种植体,成功150颗,成功率92.59%。单因素方差分析显示,3组成功率差异显著（P<0.05）;进一步两两比较,C组成功率>B组>A组（P<0.05）。共获取51例患者8年的CBCT图像（早期植入16例、延期植入20例,晚期植入15例）;CBCT和PA图像邻间骨水平差异显著（P>0.05）;3组旋入扭矩和旋出扭矩相比,差异显著（P>0.05）;植入时机、旋入扭矩、旋出扭矩是影响种植体成功率的高危因素（P<0.05）。种植体植入后8年,各组骨水平相比差异显著（P>0.05）;第2阶段手术中C组骨缺损少于A、B组（P<0.05）;无缺损种植体平均颌骨水平（bBL）低于开裂种植体（P<0.05）。结论 拔牙后种植体放置时间对种植体周围颌骨水平无显著影响,但不同时机植入可影响种植体成功率,应严格把握即刻种植适应证。

关键词: 锥形束CT, 植入时机, 种植体

Abstract: PURPOSE: To analyze 8-year cone-beam CT (CBCT) data of early, delayed and late implantation around maxillary area of patients with single dental implant after tooth extraction, and to investigate the effect of implantation at different times on implants, in order to provide valuable information for correct selection of appropriate implant timing after tooth extraction. METHODS: Clinical data of 68 patients who received single-tooth implant after tooth extraction in our hospital from January 2010 to December 2010 were retrospectively analyzed. According to different implantation times, the patients were divided into three groups: group A (n=25), group B (n=24) and group C (n=19). All patients were followed up for 8 years, and the buccal bone defects were recorded. The adjacent bone level and bone defects were analyzed based on CBCT images and posteroanterior(PA) radiographs. The data were processed with SPSS 18.0 software package. RESULTS: The success rate of mini-implants was 92.59%(150/162). Univariate analysis of variance showed that there was significant difference in the success rate of implantation among three groups(P<0.05). Paired comparison showed that the success rate of implantation among three groups was the highest in group C, followed by group B and group A (P<0.05). 8-year CBCT image data of 51 patients included 16 in group A, 20 in group B and 15 in group C. The adjacent bone levels showed no significant difference between CBCT and PA images(P>0.05). Insertion torque and pullout torque showed no significant difference among three groups(P>0.05). Implant timing, insertion torque and pullout torque were the high-risk factors affecting implant success rate(P<0.05). After 8 years of implant placement, there was no significant difference in bone level among three groups (P>0.05). In the second stage of operation, bone defect rate of group C was significantly less than that of group A and B (P<0.05). The average maxillary bone level of implants with no bone defects was lower than that of implants with dehiscence-type defects (P<0.05). CONCLUSIONS: Implant placement time after extraction has no impact on adjacent bone level, but different implant times can affect the success rate of implant; moreover, the indication of immediate implant should be strictly controlled.

Key words: Cone-beam CT, Time of implantation, Dental implant

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