Wei Y P, Xu T, Hu W J, Liu Y S, Shi Y T
Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Department of Oral Emergency, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2024 Apr 9;59(4):318-325. doi: 10.3760/cma.j.cn112144-20231123-00264.
To evaluate the survival rate, success rate, soft tissue conditions and marginal bone level changes of implants following micro crestal flap-alveolar ridge preservation at molar extraction sockets with severe periodontitis, compared to natural healing. From March 2015 to January 2017, patients scheduled for molar extraction as a consequence of severe periodontitis and planned implant-retained prostheses from Department of Periodontology Peking University School and Hospital of Stomatology were selected. A total of 40 molar extraction sockets from 40 patients received implant placement following micro crestal flap-alveolar ridge preservation or natural healing. The front consecutive 20 teeth were assigned to the natural healing group, and the back ones were assigned to the micro crestal flap-alveolar ridge preservation (MCF-ARP) group. The superstructures were placed 6 months later. Within 2 weeks (baseline) and 1, 2 and 3 years after implant crown restoration, modified plaque index, probing depth, modified bleeding index and keratinized tissue width were recorded every six months. Parallel periapical radiographs were taken to evaluate the peri-implant marginal bone level and to calculate marginal bone loss. Independent sample test or Mann-Whitney test were used to compare the differences in the above clinical and imaging indicators between the two groups. The implant survival rate and success rate of the two groups were both 100% (20/20). There were no significant differences in the modified plaque index, probing depth, modified bleeding index, buccal keratinized tissue width and marginal bone loss between two groups at 1, 2 and 3 years after implant crown restoration (all 0.05). Marginal bone loss was 0.22 (0.14, 0.34) mm in the natural healing group and 0.21 (0.12, 0.30) mm in the MCF-ARP group at a 3-year post-loading evaluation. Within the limitations of the present study, implants placed at ridge preserved and naturally healed molar extraction sockets with severe periodontitis demonstrate comparable clinical outcomes at a 3-year post-loading evaluation.
为评估重度牙周炎磨牙拔牙窝采用微嵴顶瓣牙槽嵴保存术与自然愈合相比，种植体的生存率、成功率、软组织状况及边缘骨水平变化。选取2015年3月至2017年1月北京大学口腔医学院牙周科因重度牙周炎计划拔除磨牙并计划行种植修复的患者。40例患者的40个磨牙拔牙窝在采用微嵴顶瓣牙槽嵴保存术或自然愈合后进行种植体植入。前连续20颗牙分配至自然愈合组，后连续20颗牙分配至微嵴顶瓣牙槽嵴保存（MCF-ARP）组。6个月后安装上部结构。在种植体冠修复后2周（基线）及1、2和3年，每6个月记录改良菌斑指数、探诊深度、改良出血指数和角化组织宽度。拍摄平行根尖片以评估种植体周围边缘骨水平并计算边缘骨丢失。采用独立样本t检验或Mann-Whitney U检验比较两组上述临床和影像学指标的差异。两组种植体生存率和成功率均为100%（20/20）。种植体冠修复后1、2和3年，两组改良菌斑指数、探诊深度、改良出血指数、颊侧角化组织宽度和边缘骨丢失均无显著差异（均P>0.05）。加载后3年评估时，自然愈合组边缘骨丢失为0.22（0.14，0.34）mm，MCF-ARP组为0.21（0.12，0.30）mm。在本研究的局限性内，重度牙周炎磨牙拔牙窝经牙槽嵴保存和自然愈合后植入的种植体，在加载后3年评估时显示出相当的临床结果。
