Yao Jie, Lee Koon Kay, McGrath Colman, Wu Yu Nong, Li Kar Yan, Mattheos Nikos
Oral Rehabilitation, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Jiangsu Province, School of Stomatology, Nanjing Medical University, China.
Clin Oral Implants Res. 2017 Apr;28(4):373-380. doi: 10.1111/clr.12794. Epub 2016 Mar 11.
To compare patient-centered outcome assessments (POAs) over a 2-week period after five categories of dento-alveolar surgical procedures.
A total of 339 patients in need of dento-alveolar surgical procedures such as simple tooth extraction (SE), transalveolar extraction (TE), straightforward implant placement (I), implant placement with guided bone regeneration (IGBR), and periodontal surgery (P) in Hong Kong (51.3%) and Nanjing dental clinic were consecutively recruited (2013-2015). POAs in terms of bleeding, swelling, pain, and bruising were obtained using 10 cm visual analog scale (VAS) on each day of the first week and the 14th day postsurgery. Clinical examinations were recorded on the 7th day postoperation.
For the first 3 days of healing, area-under-the-curve (AUC) analyses showed that transalveolar extraction (TE) resulted in significantly higher overall bleeding and pain (AUC: Bleeding Mean = 5.6, Pain Mean = 7.5). However, implant placement with GBR (IGBR) resulted in significant higher level of swelling (AUC: Mean = 9.1) and bruising (Mean = 4.2) for the same period with also the highest use of painkillers. Healing outcomes of straightforward implant placement (I) were comparable to that of a simple extraction (SE). Two-week overall experience showed the symptoms quickly subsided for all groups. Prevalence for complications 1 week postoperatively was IGBR (20%), P (15.6%), I (12.7%), SE (4.8%), TE (1.5%), respectively.
The highest extent of swelling and bruising was observed in patients who got implant placement with GBR (IGBR), while healing events of straightforward implants were similar to these of simple extraction. The VAS scores for all POAs parameters were generally low and decreased to nearly zero over the study period following all five surgical procedures. Low prevalence of postsurgical complications was reported.
比较五类牙槽外科手术后2周内以患者为中心的结局评估(POA)。
在香港(51.3%)和南京牙科诊所,连续招募了339例需要进行牙槽外科手术的患者,如简单拔牙(SE)、经牙槽骨拔牙(TE)、直接种植体植入(I)、引导骨再生种植体植入(IGBR)和牙周手术(P)(2013 - 2015年)。在术后第一周的每一天以及术后第14天,使用10厘米视觉模拟量表(VAS)获取关于出血、肿胀、疼痛和瘀斑方面的POA。在术后第7天进行临床检查记录。
在愈合的前3天,曲线下面积(AUC)分析显示,经牙槽骨拔牙(TE)导致总体出血和疼痛显著更高(AUC:出血均值 = 5.6,疼痛均值 = 7.5)。然而,同期引导骨再生种植体植入(IGBR)导致肿胀水平(AUC:均值 = 9.1)和瘀斑(均值 = 4.2)显著更高,且止痛药使用量也最高。直接种植体植入(I)的愈合结果与简单拔牙(SE)相当。两周的总体体验显示所有组的症状迅速消退。术后1周并发症发生率分别为IGBR(20%)、P(15.6%)、I(12.7%)、SE(4.8%)、TE(1.5%)。
接受引导骨再生种植体植入(IGBR)的患者出现的肿胀和瘀斑程度最高,而直接种植体的愈合情况与简单拔牙相似。所有POA参数的VAS评分总体较低,且在所有五种手术操作后的研究期间降至接近零。报告的术后并发症发生率较低。