北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (6): 950-953.

• 论著 • 上一篇    下一篇

因牙周炎缺失上前牙种植修复后短期软组织美学效果评价

释栋,孟焕新△,张立,张海东   

  1. (北京大学口腔医学院·口腔医院牙周科,北京100081)
  • 出版日期:2014-12-18 发布日期:2014-12-18

Esthetic outcome evaluation for soft tissue of implant restored anterior teeth lost from periodontal destruction: a case series

SHI Dong, MENG Huan-xin△, ZHANG Li, ZHANG Hai-dong   

  1. (Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China)
  • Online:2014-12-18 Published:2014-12-18

摘要: 目的:评价因牙周炎缺失上前牙种植修复后的短期软组织美学效果。方法:选择因牙周炎需拔除上前牙的患者15人,共涉及牙齿20颗,患牙两侧有天然牙,所有患者均已接受系统牙周治疗。拔牙后自然愈合2~3个月,采用常规翻瓣种植手术植入种植体,术中记录牙槽骨缺损的程度、种植体植入深度(种植体距离邻牙釉牙骨质界连线的距离)等指标,采用埋入愈合方式。愈合3个月后行二期手术并完成修复。修复后1~3个月复查,用红色美学评分(pink esthetic score,PES)评价软组织美学效果。结果:所有种植体均成功达到骨结合,没有早期种植体松动脱落发生。因牙周炎缺失的上前牙经种植修复后,PES均值为(9.6±2.4)分(5~13分),其中3颗修复体的PES低于7分。仅有水平骨缺损的13个位点种植修复后的PES均值为(10.5±1.9)分,显著高于伴有垂直向骨缺损的7个位点[(7.9±2.3)分,P<0.05]。PES与种植体植入深度呈负相关关系(r=-0.608,P<0.01)。结论:因牙周炎导致的前牙缺失存在较高的种植美学风险,牙槽骨缺损尤其是垂直骨缺损的程度和部位是影响软组织美学效果的主要因素。

关键词: 牙周炎, 牙种植, 美学, 牙科

Abstract: Objective: To evaluate the soft tissue esthetic outcome of implant restored anterior teeth lost from periodontal destruction. Methods: In the present study, 20 teeth extracted for severe periodontal destruction from 15 patients were involved. All the recruited patients received initial periodontal therapy. The implants were inserted with routine flap surgery 2-3 months after teeth extraction, and the guided bone regeneration technique was used when indicated. The extent of alveolar bone deficiency and the depth of implant placement (the distance from implant shoulder to the line connecting cemento-enamel junction of mesial and distal neighbor teeth) were recorded. The second-stage exposure and restoration were conducted after 3-month sub-mucosal healing. Pink esthetic score (PES) was used to evaluate the soft tissue esthetic outcome 1-3 months after final restoration. Results: All the implants obtained osseointegration successfully. The mean PES value was 9.6±2.4, ranging from 5 to 13. The PES values of the 3 prostheses were lower than 7. The mean PES value of the 13 sites with only horizontal bone defect was 10.5±1.9, and was significantly higher than that of the 7 sites with combined horizontal and vertical bone defect (7.9±2.3, P<0.05). The negative correlation was observed between the PES value and depth of implant placement (r=-0.608, P<0.01). Conclusion: High esthetic risk exists when restoring missing teeth lost from periodontal destruction by implant treatment. Alveolar bone defect especially vertical bone loss may mainly contribute to the soft tissue esthetic outcome deficiency.

Key words: Periodontitis, Dental implantation, Esthetics, dental

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