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利用临床参数预测美学区域即刻种植位点的骨和软组织改变。

Predicting bone and soft tissue alterations of immediate implant sites in the esthetic zone using clinical parameters.

机构信息

Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center School of Dentistry, Houston, Texas, USA.

Division of Periodontics, Section of Oral and Diagnostic Sciences, Columbia University College of Dental Medicine, New York, New York, USA.

出版信息

Clin Implant Dent Relat Res. 2020 Jun;22(3):325-332. doi: 10.1111/cid.12910. Epub 2020 Apr 28.

Abstract

BACKGROUND

Immediate implantation is generally a predictable treatment, but sometimes there are significant tissue alterations at the surgical site which compromise clinical outcomes.

PURPOSE

This study aimed to investigate the association between tissue alterations and different clinical parameters in esthetic areas following immediate implant placement and provisionalization.

MATERIALS AND METHODS

Clinical parameters were measured at 36 non-grafted immediate implant sites enrolled in a randomized controlled trial. Alterations of bone and soft tissue were measured at 12 months after the treatment. Stepwise linear regression analysis was performed to analyze the association between different clinical parameters and outcomes of interest.

RESULTS

Gingival thickness 3 mm apical to the gingival margin (GT3) was positively associated with recession of mid-buccal gingival margin, while vertical distance between the buccal gingival margin and the crest (GM-bone) was negatively associated (P = .03, .01). Flap elevation and older age were positively associated with recession of the interproximal gingival margin (P = .04, .01). Horizontal defect dimension was positively associated with buccal ridge dimensional reduction while gingival thickness at free gingival margin (GT1) was negatively associated (P = .01, .04). Regarding interproximal bone level change, none of the clinical parameters was significantly associated.

CONCLUSIONS

Gingival phenotype was the only parameter significantly associated with both buccal gingival recession and buccal ridge dimensional reduction. It is important to assess clinical parameters before and during immediate implant procedure.

摘要

背景

即刻种植通常是一种可预测的治疗方法,但有时在手术部位会出现明显的组织改变,从而影响临床效果。

目的

本研究旨在探讨即刻种植和临时修复后,美学区即刻种植体植入和临时修复后组织改变与不同临床参数的关系。

材料与方法

本研究共纳入 36 例非植骨即刻种植患者,采用随机对照试验进行研究。在治疗后 12 个月时测量骨和软组织的改变。采用逐步线性回归分析,分析不同临床参数与研究结果之间的关系。

结果

牙龈缘 3mm 处牙龈厚度(GT3)与颊侧龈缘退缩呈正相关,而颊侧龈缘与牙槽嵴之间的垂直距离(GM-骨)与颊侧龈缘退缩呈负相关(P =.03,.01)。瓣提升和年龄较大与近中牙龈退缩呈正相关(P =.04,.01)。水平缺损维度与颊侧牙槽嵴的尺寸减少呈正相关,而游离龈缘的牙龈厚度(GT1)与颊侧牙槽嵴的尺寸减少呈负相关(P =.01,.04)。关于近中骨水平变化,没有任何临床参数与它显著相关。

结论

牙龈表型是唯一与颊侧龈退缩和颊侧牙槽嵴尺寸减少均显著相关的参数。在即刻种植手术前和手术期间评估临床参数非常重要。

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