Wu Shi-Qing, Lu Hai-Bin, Wen Zhi-Xin, Zhang Xue-Yang, Chen Guo-Dong
Shunde Hospital of Southern Medical University, First People's Hospital of Shunde. Foshan 528000, China. E-mail:
Shanghai Kou Qiang Yi Xue. 2020 Dec;29(6):617-622.
To evaluate the clinical aesthetic effect of buccal alveolar ridge preservation (ARP) and connective tissue transplantation (CTG) in patients who received a single implant.
Forty-three patients with tooth loss admitted to the Department of Stomatology of Shunde Hospital of Southern Medical University from May 2014 to May 2016 were included in the study. Tooth extraction, ARP, implant implantation, CTG and permanent repair were performed respectively. The incidence of bleeding, depth of probing, marginal bone resorption, and red-white aesthetic effect of implants were evaluated 1 year and 3 years after surgery. The buccal mucosa thickness of implants before, immediately after CTG, 1 year and 3 years after surgery were measured. The patient satisfaction was evaluated by visual analogue scale (VAS) from masticatory function, overall aesthetics, attachment height, and color, respectively. The implant conditions at the third year after surgery were observed, and complications during follow-up were recorded. SPSS 20.0 software package was used for statistical analysis of the data.
The follow-up rate in the first year after surgery was 100%, and that in the third year after surgery was 90.70%. One year and 3 years after operation, the aesthetic effect of the implant was satisfactory. At the 3rd year after operation, the scores of the near middle gingival papillary were significantly higher than that at the 1st year after operation (P<0.05). The buccal mucosal thickness of the implant immediately after CTG and 1 year and 3 years after surgery increased significantly compared with that before CTG (P<0.05). The buccal mucosal thickness of the implant increased 1.02 mm (relative stability: 90.12%) 1 year after operation and 1.01 mm (relative stability: 84.31%) 3 years after operation, respectively. The satisfaction scores of the patients on chewing function, overall aesthetics, attachment height and color of the implant immediately after CTG, one year after surgery and 3 years after surgery were all > 8. The 3-year survival rate of the implants was 100%, and the 3-year success rate of the implants was 97.44%. During the follow-up, two patients developed peri-implant mucositis, which was relieved after tooth cleaning, but no complications such as tissue flap necrosis, limited opening and tongue movement disorder occurred.
ARP and CTG have good clinical and aesthetic effects on patients with tooth loss. In three years, the buccal mucosal thickness of the implant can be increased and relatively stable, which is worthy of clinical promotion and application.
评估颊侧牙槽嵴保存(ARP)联合结缔组织移植(CTG)在单颗种植患者中的临床美学效果。
纳入2014年5月至2016年5月在南方医科大学顺德医院口腔科就诊的43例牙列缺损患者。分别进行拔牙、ARP、种植体植入、CTG及永久修复。于术后1年和3年评估种植体的出血发生率、探诊深度、边缘骨吸收情况及红白色美学效果。测量种植体术前、CTG术后即刻、术后1年及3年的颊侧黏膜厚度。采用视觉模拟量表(VAS)分别从咀嚼功能、整体美观、附着高度及颜色方面评估患者满意度。观察术后第3年种植体情况,记录随访期间的并发症。采用SPSS 20.0软件包对数据进行统计学分析。
术后第1年随访率为100%,术后第3年随访率为90.70%。术后1年和3年,种植体美学效果满意。术后第3年,近中牙龈乳头评分显著高于术后第1年(P<0.05)。CTG术后即刻、术后1年及3年种植体颊侧黏膜厚度较CTG术前显著增加(P<0.05)。术后1年种植体颊侧黏膜厚度增加1.02 mm(相对稳定性:90.12%),术后3年增加1.01 mm(相对稳定性:84.31%)。CTG术后即刻、术后1年及3年患者对种植体咀嚼功能、整体美观、附着高度及颜色的满意度评分均>8分。种植体3年生存率为100%,3年成功率为97.44%。随访期间,2例患者发生种植体周围黏膜炎,经洗牙后缓解,未发生组织瓣坏死、开口受限及舌运动障碍等并发症。
ARP联合CTG对牙列缺损患者具有良好的临床及美学效果。3年内种植体颊侧黏膜厚度可增加且相对稳定,值得临床推广应用。