摘要
目的分析上颌前牙骨缺损形态与引导骨再生术(GBR)后骨吸收率的关系。方法选取2020年1月至2021年12月就诊于杭州口腔医院种植科,由同一术者行上颌前牙区种植体植入同期行GBR的患者20例。分析患者术前、术后即刻、术后6个月的锥形束投照计算机体层摄影系统数据,采用六维齿科牙设计软件拟合,测量术前骨缺损近远中向、唇舌向、冠根向骨缺损最大径及牙槽骨凹陷角度4个骨缺损形态指标。比较患者距种植体颈部不同位点术后即刻骨增量、骨吸收量、骨吸收率;分析骨缺损形态、术后即刻骨增量与GBR后骨吸收率的相关性;分析患者GBR后骨吸收率的影响因素。结果距种植体颈部3、6 mm处的术后即刻骨壁厚度及术后即刻骨增量均>9 mm处(均P<0.05)。距种植体颈部3、6 mm处骨吸收量均>9 mm处(均P<0.05)。距种植体颈部3 mm处骨吸收率<6 mm处<9 mm处(均P<0.05)。距种植体颈部3、6、9 mm处的骨吸收率与唇舌向骨缺损最大径呈负相关(r=-0.678、-0.553、-0.487,均P<0.05),与冠根向骨缺损最大径、牙槽骨凹陷角度均呈正相关(r=0.845、0.547、0.633;0.877、0.619、0.599,均P<0.05),而与近远中向骨缺损、术后即刻骨增量均无相关性(均P>0.05)。在一定范围内拥有较大的唇舌向骨缺损最大径,较小冠根向骨缺损最大径及牙槽骨凹陷角度的骨缺损患者行GBR后,距种植体颈部3 mm处的骨吸收率较低(均P<0.05);9 mm处的骨吸收率仅受到冠根向骨缺损最大径的影响(P<0.05);骨缺损形态对种植体颈部6 mm处骨吸收率的影响无统计学意义(均P>0.05)。结论GBR难点在于维持种植体颈部3 mm处植骨材料的稳定,其中骨缺损形态是影响种植体颈部骨吸收率的关键因素:具有较大的唇舌向骨缺损、较小的冠根向骨缺损及较小的骨凹陷角度的牙槽骨形态是相对有利型骨缺损,对其行GBR后的骨吸收率相对较低。
Objective To analyze the relationship between bone defect morphology of maxillary anterior region and bone resorption rate after guided bone regeneration(GBR).Methods Twenty patients patients who were treated in the Department of Implantology,Hangzhou Stomatological Hospital from January 2020 to December 2021 were enrolled.The bone implantation and GBR in maxillary anterior region were performed simultaneously by a same dentist.Cone beam projection computed tomography images before surgery,immediately and 6 months after surgery were analyzed,and six dimensional dental dental design software was used to fit them.The lip-lingual direction,crown-root direction bone defect maximum diameter and alveolar bone concave angle 4 bone defect morphological indicators were measured.The differences in the immediate postoperative bone augmentation,bone resorption and bone resorption rate were compared among patients with defect at different sites from the implant neck.The correlation of bone defect morphology and immediate postoperative bone augmentation with bone resorption rate after GBR was analyzed,and the influencing factors of bone resorption rate after GBR were analyzed.Results Immediate postoperative bone wall thickness,immediate postoperative bone augmentation,and bone resorption at 3 and 6 mm from the implant neck were greater than those at 9 mm(all P<0.05).The bone resorption rate at 3 mm from the implant neck was lower than that at 6 mm and 9 mm(all P<0.05).The bone resorption rate at 3,6,and 9 mm from the implant neck was negatively correlated with the maximum diameter of the labio-lingual bone defect(r=-0.678,-0.553,-0.487,all P<0.05),and was significantly correlated with the crown-root direction.The maximum diameter of the bone defect and the alveolar bone concave angle were positively correlated(r=0.845,0.547,0.633;0.877,0.619,0.599,all P<0.05),while not correlated with medial-distal bone defect and the immediate postoperative bone increase(all P>0.05).Within a certain range,the bone resorption rate at 3 mm from
作者
汪婷
涂业颖
于艳春
林海燕
WANG Ting;TU Yeying;YU Yanchun;LIN Haiyan(School of Stomatology,Zhejiang Chinese Medical University,Hangzhou 310053,China)
出处
《浙江医学》
CAS
2022年第19期2089-2093,I0007,共6页
Zhejiang Medical Journal
基金
浙江省基础公益研究计划项目(LGJ19H140001)
浙江中医药大学研究生科学研究基金项目(2021YKJ15)。
关键词
骨缺损形态
引导骨再生术
骨吸收率
Bone defect morphology
Guided bone regeneration
Bone resorption rate
