Chen Zhaozhao, Li Junying, Wang Hom-Lay, Yu Haiyang
Int J Oral Maxillofac Implants. 2019 Mar/Apr;34(2):521-528. doi: 10.11607/jomi.6750.
The aim of this cone beam computed tomography (CBCT) study was to assess bone volume changes in molar sites after modified immediate implant placement with xenografts.
This prospective study was performed between June 2015 and September 2016. Surgical procedures included modified implant site preparation, atraumatic tooth extraction, implant placement, and bone grafting with deproteinized bovine bone mineral. CBCT scans were taken at the day of surgery and 6 months after surgery. Horizontal and vertical bone dimensional changes were evaluated through these two CBCTs, including variations of horizontal bone thickness (HBT), vertical bone height (VBH), and the distance from the implant platform to the tip of the intradental bone peak (DIP).
Fifteen patients with 17 hopeless molars were included, and no implant was lost during the observation period. With measurements at five different parallel levels (0, 1, 2, 4, and 6 mm apical to the implant platform), the mean HBT in millimeters and percentage between these two time points ranged from -0.88 (33%) to -0.03 (0.7%) buccally and -0.45 (12%) to -0.02 (0.4%) lingually. The change of VBH was greater buccally (0.74 ± 0.32 mm, P < .01) than lingually (0.40 ± 0.17 mm). DIP was reduced 0.46 ± 0.27 mm mesially and 0.39 ± 0.21 mm distally.
In molar sites, flapless modified immediate implant placement with deproteinized bovine bone is a predictable treatment. However, the dimensional change of the ridge should still be expected, and buccal bone resorption is more evident than lingual.
本锥形束计算机断层扫描(CBCT)研究的目的是评估采用异种移植物进行改良即刻种植后磨牙部位的骨体积变化。
本前瞻性研究于2015年6月至2016年9月进行。手术步骤包括改良种植部位制备、无创拔牙、种植体植入以及用脱蛋白牛骨矿物质进行骨移植。在手术当天和术后6个月进行CBCT扫描。通过这两次CBCT评估水平和垂直骨尺寸变化,包括水平骨厚度(HBT)、垂直骨高度(VBH)以及从种植体平台到牙内骨嵴顶的距离(DIP)的变化。
纳入15例患有17颗无保留价值磨牙的患者,观察期内无种植体丢失。在种植体平台根尖方向的五个不同平行水平(0、1、2、4和6mm)进行测量,两个时间点之间的平均HBT(毫米)和百分比在颊侧为-0.88(33%)至-0.03(0.7%),舌侧为-0.45(12%)至-0.02(0.4%)。VBH的变化在颊侧(0.74±0.32mm,P<.01)大于舌侧(0.40±0.17mm)。DIP在近中减少0.46±0.27mm,远中减少0.39±0.21mm。
在磨牙部位,采用脱蛋白牛骨进行无瓣改良即刻种植是一种可预测的治疗方法。然而,仍应预期牙槽嵴的尺寸变化,且颊侧骨吸收比舌侧更明显。