| 摘要: |
| 目的 调查后牙区不同种植体早期边缘骨的吸收情况，并探究其相关影响因素。方法 回顾性分析2013年2月至2016年2月行骨组织水平种植体后牙区种植修复的96例患者（骨组织水平种植组）和同期行软组织水平种植体后牙区种植修复的104例患者（软组织水平种植组）的临床资料。所有患者均于种植体植入后即刻及植入后12周时行X线检查，以种植体边缘牙槽骨高度变化情况作为早期边缘骨吸收的评估依据，比较骨组织水平种植组和软组织水平种植组患者早期近中、远中边缘骨吸收情况；记录12周时牙周健康状态指标[菌斑指数（PLI）、出血指数（SBI）、探诊深度（PD）]及种植修复体边缘密合情况；于种植后4周内检测并比较2组疼痛评分[数字疼痛分级法（NRS）]的差异。依据早期边缘骨吸收检测结果将200例患者分为优良组（骨吸收量<1.5 mm）和不良组（骨吸收量≥ 1.5 mm），比较2组患者年龄、性别、缺牙位置、种植体局部卫生情况、种植体直径、种植体长度、种植方式、吸烟情况等一般资料的差异，采用logistic回归模型分析影响种植体早期边缘骨吸收的独立危险因素。结果 种植体植入后12周时骨组织水平种植组和软组织水平种植组患者的种植体早期近中与远中边缘骨吸收评估结果、牙周健康状态指标（PLI、SBI、PD）检测结果及种植修复体边缘密合A级率差异均无统计学意义（P均>0.05），种植后4周内NRS评分比较差异无统计学意义（P>0.05）。骨吸收优良组（n=148）和不良组（n=52）患者的年龄、性别、缺牙位置、种植体直径、种植体长度等一般资料差异均无统计学意义（P均>0.05）；logistic回归分析结果显示，非埋入式种植、种植体局部卫生环境不佳、吸烟是影响种植体早期边缘骨吸收的独立危险因素（P均<0.05）。结论 骨组织水平种植体和软组织水平种植体早期边缘骨吸收情况类似，均在后牙区种植修复治疗中具有较高的应用价值；非埋入式种植、种植体局部卫生环境不佳和长期吸烟与种植体早期边缘骨吸收关系密切，需引起重视。 |
| 关键词: 后牙 种植体 骨吸收 影响因素 |
| DOI：10.16781/j.0258-879x.2018.02.0134 |
| 投稿时间：2017-06-06修订日期：2017-09-24 |
| 基金项目: |
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| Investigation of early marginal bone resorption of different implants in posterior-tooth areas and its influencing factors |
| XIAO Sha,GAO Cheng-zhi*,ZHOU Dong-ping |
(Department of Stomatology, People's Hospital of Peking University, Beijing 100044, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the state of early marginal bone resorption of different implants in posterior-tooth areas and to explore the related influencing factors. Methods The clinical data were retrospectively analyzed in 96 patients undergoing posterior implant restoration with bone tissue level implants (bone tissue level implant group) and 104 patients with soft tissue level implants (soft tissue level implant group) from Feb. 2013 to Feb. 2016. All patients underwent X-ray examination immediately and at 12 weeks after implantation. With the changes of implants marginal alveolar bone heights as the evaluation basis of early marginal bone resorption, the early mesial and distal marginal bone losses were compared between the two groups. The differences in periodontal health indexes (plaque index[PLI], bleeding index[SBI] and probing depth[PD]) and marginal fitness of implants at 12 weeks after implantation were recorded and analyzed. Pain score (numerical rating scale[NRS]) within 4 weeks after implantation were compared between the two groups. The 200 patients were divided into excellent group (bone resorption<1.5 mm) and poor group (bone absorption ≥ 1.5 mm) according to the state of early marginal bone loss. The general data, including age, gender, location of missed teeth, local health of implant, implant diameter, implant length, implanting methods, and smoking, were compared between the two groups. The independent risk factors of early marginal bone resorption of implants were analyzed by logistic regression analysis. Results There were no significant differences in early mesial or distal marginal bone losses, periodontal health indexes (PLI, SBI, or PD) or grade A rate of marginal fitness of implants between the bone tissue level implant group and soft tissue level implant group at 12 weeks after implantation (all P>0.05); there was no significant difference in NRS score between the two groups within 4 weeks after implantation (P>0.05). The differences in age, gender, location of missed teeth, implant diameter, implant length and other general data were not statistically significant between the excellent group (n=148) and the poor group (n=52, all P>0.05). Logistic regression analysis showed that non-embedded implanting, poor local health environment of implant and smoking were independent risk factors of early implant marginal bone resorption (all P<0.05). Conclusion Bone tissue level implant and soft tissue level implant have similar early marginal bone resorption and high value in posterior-teeth implant restoration. Non-embedded implanting, poor local health environment of implant and smoking are closely related to early marginal bone resorption and need to be taken into account. |
| Key words: posterior teeth implant bone resorption influencing factor |
