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基于锥形束计算机断层扫描的上颌前牙种植体周围牙槽骨改变和灰度值变化:1-3 年的临床回顾性研究。

Facial alveolar bone alterations and gray value changes based on cone beam computed tomography around maxillary anterior implants: A clinical retrospective study of 1-3 years.

机构信息

The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China.

出版信息

Clin Oral Implants Res. 2020 May;31(5):476-487. doi: 10.1111/clr.13583. Epub 2020 Feb 12.

Abstract

OBJECTIVES

The purpose of this cone beam computed tomography (CBCT) study was to describe facial alveolar bone alterations and gray value (GV) changes around implants in aesthetic anterior maxilla with simultaneous guided bone regeneration (GBR) and to investigate potential influence of factors related to vertical alveolar bone stability, such as particle sizes of the deproteinized bovine bone mineral (DBBM) used.

MATERIALS AND METHODS

A retrospective study design was adopted. Four facio-palatal cross-sectional CBCT images of 166 implants from 124 patients who had maxillary anterior implants were obtained. Measurements of the vertical facial alveolar bone level (VFBL), horizontal facial alveolar bone thickness (HFBT), and GV were identified of 1-3 years. Then, correlation coefficients for those parameters were calculated. Finally, linear mixed models were established to investigate potential factors influencing vertical alveolar bone resorption.

RESULTS

Facial alveolar bone underwent fast bone modeling and remodeling during the first 6 months, with decreases of 1.00 ± 1.19 and 0.74 ± 0.86 mm in VFBL and HFBT in implant shoulder, respectively, and there was positive and significant correlation between the alterations in VFBL and HFBT1 (r  = .516, p = .000). Linear mixed models identified particle size of DBBM as a critical factor associated with vertical bone resorption (p = .000). The GV gradually increased during the follow-up period.

CONCLUSIONS

Rapid and unavoidable peri-implant bone resorption usually happened during the first 6 months after implant placement. GBR is a predictable treatment for maxillary anterior implants, since GV has an increasing trend. Large bone particles of DBBM help maintain vertical alveolar bone stability.

摘要

目的

本锥形束 CT(CBCT)研究的目的是描述同时进行引导骨再生(GBR)的美学上前牙槽嵴的面部牙槽骨改变和种植体周围的灰度值(GV)变化,并探讨与垂直牙槽骨稳定性相关的因素的潜在影响,如使用的脱蛋白牛骨矿物质(DBBM)的颗粒大小。

材料和方法

采用回顾性研究设计。从 124 名上颌前牙种植患者的 166 个种植体中获得了 4 个面腭横断面 CBCT 图像。测量了 1 至 3 年的垂直面牙槽骨水平(VFBL)、水平面牙槽骨厚度(HFBT)和 GV。然后计算了这些参数的相关系数。最后,建立线性混合模型来研究潜在影响垂直牙槽骨吸收的因素。

结果

在最初的 6 个月内,面部牙槽骨经历了快速的骨建模和重塑,种植体肩部的 VFBL 和 HFBT 分别减少了 1.00±1.19 和 0.74±0.86mm,VFBL 和 HFBT1 的变化之间存在正相关且显著(r=0.516,p=0.000)。线性混合模型确定 DBBM 的颗粒大小是与垂直骨吸收相关的关键因素(p=0.000)。GV 在随访期间逐渐增加。

结论

种植体放置后最初 6 个月内通常会发生快速且不可避免的种植体周围骨吸收。GBR 是上颌前牙种植的一种可预测的治疗方法,因为 GV 呈上升趋势。较大的 DBBM 骨颗粒有助于维持垂直牙槽骨稳定性。

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