即刻种植术后颊侧间隙宽度对颊侧骨壁的影响：回顾性锥形束 CT 分析。
Effect of the buccal gap width following immediate implant placement on the buccal bone wall: A retrospective cone-beam computed tomography analysis.
机构信息
Pennsylvania Center for Dental Implants and Periodontics, Philadelphia, Pennsylvania, USA.
Department of Periodontology and Implantology, Temple University Kornberg School of Dentistry, Philadelphia, Pennsylvania, USA.
出版信息
Clin Implant Dent Relat Res. 2022 Aug;24(4):403-413. doi: 10.1111/cid.13095. Epub 2022 May 23.
BACKGROUND
The effect of the buccal gap width on the clinical outcome of socket graft and immediate implant placement (IIP) at maxillary central incisor sites has not been investigated. Thus, the aim of the present study was to evaluate the effect of the width of the buccal gap on the thickness of the newly formed buccal wall.
METHODS
Forty-two patients and 51 maxillary central incisor sites treated with IIP and ridge preservation by means of graft of the buccal gap at the maxillary central incisor region were included in the study. The width of the buccal gap was measured and filled with deproteinized bovine bone mineral. Implant sites were divided into two groups: wide gap (WG, >2 mm; n = 34) and narrow gap (NG, ≤2 mm; n = 17). After at least 1 year in function (5 ± 4), CBCT scans were obtained and assessed by a calibrated examiner. The thickness of the buccal and palatal bone walls, the percentage of the implant height covered by bone in the buccal and palatal aspects and the position of the buccal and palatal crests were compared between the two groups. A linear regression model was performed to assess predictors of the thickness of the buccal bone.
RESULTS
The buccal bone was significantly thicker in the WG group than the NG group at all levels observed (overall 1.9 ± 0.9 mm and 0.5 ± 0.6 mm, respectively). The thickness of the palatal bone was similar between both groups (>2 mm). The percentage of the implant height covered by bone at the buccal aspect was significantly higher in the WG group (95 ± 16.6%) than in the NG group (59.4 ± 42.3%). The position of the buccal crest in relation to the implant shoulder was significantly more coronal (0.3 ± 2.2 mm) in the WG group than in the NG group (-4.7 ± 5.6 mm). The regression analysis model indicated that the width of the buccal gap was the only predictor of the thickness of the newly formed buccal bone wall (p < 0.001).
CONCLUSION
Grafting of >2 mm-wide buccal gaps following IIP promoted a thicker buccal bone wall.
背景
尚未研究颊间隙宽度对上颌中切牙部位种植窝骨增量和即刻种植（IIP）的临床效果的影响。因此，本研究旨在评估颊间隙宽度对新形成的颊侧骨壁厚度的影响。
方法
本研究纳入了 42 名患者和 51 颗上颌中切牙，这些患者接受了 IIP 和通过在上颌中切牙区域颊侧间隙植骨进行的牙槽嵴保存治疗。测量颊间隙的宽度并用脱蛋白牛骨矿物质填充。种植部位分为两组：宽间隙（WG，>2mm；n=34）和窄间隙（NG，≤2mm；n=17）。在功能至少 1 年后（5±4），获得 CBCT 扫描并由经过校准的检查者进行评估。比较两组之间颊侧和腭侧骨壁的厚度、颊侧和腭侧骨覆盖种植体高度的百分比以及颊侧和腭侧嵴的位置。进行线性回归模型以评估颊侧骨厚度的预测因子。
结果
在所有观察到的水平上，WG 组的颊侧骨均明显比 NG 组厚（总体分别为 1.9±0.9mm 和 0.5±0.6mm）。两组的腭侧骨厚度相似（>2mm）。在 WG 组，颊侧骨覆盖种植体高度的百分比明显更高（95±16.6%），而在 NG 组（59.4±42.3%）则较低。颊侧嵴相对于种植体肩部的位置在 WG 组比在 NG 组更向冠方（0.3±2.2mm），而在 NG 组更向根方（-4.7±5.6mm）。回归分析模型表明，颊间隙的宽度是新形成的颊侧骨壁厚度的唯一预测因子（p<0.001）。
结论
在 IIP 后植入>2mm 宽的颊侧间隙可促进更厚的颊侧骨壁形成。
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