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牙周病损患者拔牙窝内牙槽嵴保存与不保存的回顾性研究。

Retrospective study of alveolar ridge preservation compared with no alveolar ridge preservation in periodontally compromised extraction sockets.

机构信息

One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea.

Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.

出版信息

Int J Implant Dent. 2021 Mar 26;7(1):23. doi: 10.1186/s40729-021-00305-2.

Abstract

BACKGROUND

To minimize alveolar bone resorption, alveolar ridge preservation (ARP) has been proposed. Recently, interest in improving the feasibility of implant placement has gradually increased, especially in situations of infection such as periodontal and/or endodontic lesions. The aim of this study was to investigate if ARP improves feasibility of implant placement compared with no ARP in periodontally compromised sites. Secondary endpoints were the necessity of bone graft at the time of implant placement and implant failure before loading at ARP compared with no ARP.

MATERIAL AND METHODS

This retrospective study was performed using dental records and radiographs obtained from patients who underwent tooth extraction due to chronic periodontal pathology. Outcomes including the feasibility of implant placement, horizontal bone augmentation, vertical bone augmentation, sinus floor elevation, total bone augmentation at the time of implant placement, and implant failure before loading were investigated. Multivariable logistic regression analysis was performed to examine the influence of multiple variables on the clinical outcomes.

RESULTS

In total, 418 extraction sites (171 without ARP and 247 with ARP) in 287 patients were included in this study. The ARP group (0.8%) shows significantly lower implant placement infeasibility than the no ARP group (4.7%). Horizontal and vertical bone augmentations were significantly influenced by location and no ARP. Total bone augmentation was significantly influenced by sex, location, and no ARP.

CONCLUSION

ARP in periodontally compromised sites may improve the feasibility of implant placement. In addition, ARP attenuate the severity of the bone augmentation procedure.

摘要

背景

为了尽量减少牙槽骨吸收,提出了牙槽嵴保存(ARP)。最近,人们对提高种植体放置可行性的兴趣逐渐增加,尤其是在牙周和/或牙髓病变等感染情况下。本研究旨在探讨在牙周受损部位,ARP 是否比不进行 ARP 更能提高种植体放置的可行性。次要终点是在种植体放置时是否需要骨移植,以及在 ARP 与不进行 ARP 时,种植体在加载前失败的情况。

材料和方法

本回顾性研究使用从因慢性牙周病接受拔牙的患者中获得的牙科记录和 X 光片进行。研究的结果包括种植体放置的可行性、水平骨增量、垂直骨增量、窦底提升、种植体放置时的总骨增量以及种植体在加载前失败的情况。采用多变量逻辑回归分析来检查多个变量对临床结果的影响。

结果

本研究共纳入了 287 名患者的 418 个拔牙部位(171 个未进行 ARP,247 个进行了 ARP)。ARP 组(0.8%)的种植体放置不可行性明显低于无 ARP 组(4.7%)。水平和垂直骨增量明显受位置和无 ARP 的影响。总骨增量明显受性别、位置和无 ARP 的影响。

结论

在牙周受损部位进行 ARP 可能会提高种植体放置的可行性。此外,ARP 减轻了骨增量手术的严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b143/7994480/defcae6a9c02/40729_2021_305_Fig1_HTML.jpg

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