位点保存对牙周病患者牙周状况影响的临床研究

doi:10.13701/j.cnki.kqyxyj.2020.11.009

摘要/Abstract

摘要： 目的:探讨位点保存对牙周病患者龈沟出血指数(Sulcus Bleeding Index,SBI)、探诊深度(Proing Depth,PD)、牙周附着丧失 (Attachment Lossl,AL)及菌斑指数(Plaque Index,PLI)的影响。方法:选择2018年2月~2019年1月在我院接受治疗的牙周病患者94例进行研究。采用随机数字表法将患者分2组,各47例。对照组行常规拔牙后种植修复治疗,观察组行位点保存拔牙后种植修复治疗。比较两组患者种植成功率、修复效果、SBI、PD、AL、PLI、患者主观评价结果。结果:观察组种植成功率为100%(47/47),高于对照组的89.36%(42/47),差异有统计学意义(P<0.05)。观察组总优良率为95.75%,高于对照组的82.98%(P<0.05)。治疗前两组SBI、PD、AL及PLI差异均无统计学意义(P>0.05),治疗后两组SBI、PD、AL及PLI均明显下降(P<0.05),但治疗后SBI、PLI差异无统计学意义(P>0.05),观察组PD、AL显著低于对照组(P<0.05)。治疗后两组患者咀嚼功能、外形美观及整体满意度均明显提升,但观察组治疗后咀嚼功能、外形美观及整体满意度均显著高于对照组(P<0.05)。结论:位点保存拔牙后种植修复治疗较常规拔牙可明显提高牙周病患者种植成功率,提高修复优良率,降低PD及AL,并提高患者咀嚼功能、外形美观及整体满意度。

关键词: 位点保存, 拔牙, 种植牙, 牙周病

Abstract: Objective: To explore the effect of site preservation on sulcus bleeding index (SBI), probing depth (PD), attachment loss (AL), and plaque index (PLI) in patients with periodontal disease. Methods: A total of 94 patients with periodontal disease who were treated in our hospital from February 2018 to January 2019 were selected. The patients were randomly divided into 2 groups, with 47 cases each. The control group underwent conventional implantation and restoration after tooth extraction, and the observation group underwent site preservation after tooth extraction. The implantation success rate, repair effect, SBI, PD, AL, PLI, and subjective evaluation results were compared between two groups of patients. Results: The implantation success rate of observation group was 100% (47/47), which was higher than that of control group (89.36%, 42/47, P<0.05). The total excellent and good rate in the observation group was 95.75%, which was higher than 82.98% in the control group (P<0.05). There was no significant difference in SBI, PD, AL, and PLI between two groups before treatment (P>0.05). After treatment, the SBI, PD, AL, and PLI in the two groups were significantly reduced (P<0.05), but the SBI and PLI were different after treatment. There was no statistical significance (P>0.05). PD and AL in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the masticatory function, appearance, and overall satisfaction of two groups were significantly improved, but the masticatory function, appearance, and overall satisfaction of the observation group were significantly higher than those of control group (P<0.05). Conclusion: Site preservation after extraction can significantly improve the success rate of implantation in patients with periodontal disease, improve the rate of excellent repair, reduce PD and AL, and improve patients' chewing function, appearance, and overall satisfaction

Key words: site preservation, tooth extraction, dental implant, periodontal disease

耿双双, 王健, 杨莉, 冯欣欣, 路立花. 位点保存对牙周病患者牙周状况影响的临床研究[J]. 口腔医学研究, 2020, 36(11): 1022-1026.

GENG Shuangshuang, WANG Jian, YANG Li, FENG Xinxin, LU Lihua. Effect of Site Preservation on Periodontal Status of Periodontal Patients[J]. Journal of Oral Science Research, 2020, 36(11): 1022-1026.

参考文献

[1] 刘月芳,朱光勋.音乐治疗与牙周病的治疗[J].口腔医学研究,2018,34(1):100-102.
[2] 欧阳翔英.关于重度牙周炎的诊断标准[J].中华口腔医学杂志,2017,52(2):72-74.
[3] Duong M, Mealey BL, Walker C, et al. Evaluation of healing at molar extraction sites with and without ridge preservation: A three‐arm histologic analysis [J]. J Periodontol, 2020, 91(1): 74-82.
[4] 蔡伊琳,孟子堰,王春,等.牙周专科门诊9942例患者的临床流行病学资料分析[J].口腔医学研究,2019,35(09):850-853.
[5] Zhao L, Xu T, Hu W, et al. Preservation and augmentation of molar extraction sites affected by severe bone defect due to advanced periodontitis: A prospective clinical trial [J]. Clin Implant Dent R, 2018, 20(3): 333-344.
[6] Wei Y, Bi X, Hu W, et al. Evaluation of Dental Implants Following Ridge Preservation in Molar Extraction Sockets Affected by Advanced Periodontitis: A 30-Month Postloading Case Series [J]. Dentistry, 2018, 8(505): 2161-1122.
[7] Kim JJ, Ben Amara H, Schwarz F, et al. Is ridge preservation/augmentation at periodontally compromised extraction sockets safe? A retrospective study [J]. J Clin Periodontolo, 2017, 44(10): 1051-1058.
[8] Sad LM, Haddad JCV, da Costa Lourenço D, et al. Alvelar ridge preservation: a systematic review [J]. Rev Bras Cien Med Saúde, 2017, 5(5): 1-6.
[9] Ustaoglu G, Ercan E, Tunali M. Low-level laser therapy in enhancing wound healing and preserving tissue thickness at free gingival graft donor sites: a randomized, controlled clinical study [J]. Photomed Laser Surg, 2017, 35(4): 223-230.
[10] 台保军.中国居民口腔健康状况及防控策略, 第四次全国口腔健康流行病学调查结果解读[C]// 第十三次全国老年口腔医学学术年会.2018.
[11] Maiorana C, Poli PP, Deflorian M, et al. Alveolar socket preservation with demineralised bovine bone mineral and a collagen matrix [J]. J Periodontal Implant, 2017, 47(4): 194-210.
[12] Greenwell H, Wang HL, Kornman KS, et al. Biologically guided implant therapy: A diagnostic and therapeutic strategy of conservation and preservation based on periodontal staging and grading [J]. J Periodontolo, 2019, 90(5): 441-444.
[13] Nart J, Barallat L, Jimenez D, et al. Radiographic and histological evaluation of deproteinized bovine bone mineral vs. deproteinized bovine bone mineral with 10% collagen in ridge preservation. A randomized controlled clinical trial [J]. Clin Oral Implants Res, 2017, 28(7): 840-848.
[14] Fischer KR, Mühlemann S, Jung RE, et al. Dimensional Evaluation of Different Ridge Preservation Techniques with a Bovine Xenograft: A Randomized Controlled Clinical Trial [J]. Int J Periodontolo Dentist, 2018, 38(4): 549-556.
[15] Cho IW, Park JC, Shin HS. A comparison of different compressive forces on graft materials during alveolar ridge preservation [J]. J Periodontal Implan, 2017, 47(1): 51-63.
[16] Bozbay E, Dominici F, Gokbuget AY, et al. Preservation of root cementum: a comparative evaluation of power‐driven versus hand instruments [J]. Int J dent Hygiene, 2018, 16(2): 202-209.
[17] Cosyn J, Cleymaet R, De Bruyn H. Predictors of alveolar process remodeling following ridge preservation in high‐risk patients [J]. Clin Implant Denti R, 2016, 18(2): 226-233.
[18] Apostolopoulos P, Darby I. Retrospective success and survival rates of dental implants placed after a ridge preservation procedure [J]. Clin Oral Implan Res, 2017, 28(4): 461-468.
[19] Kim JJ, Schwarz F, Song HY, et al. Ridge preservation of extraction sockets with chronic pathology using Bio‐Oss^® Collagen with or without collagen membrane: an experimental study in dogs [J]. Clin Oral Implan Res, 2017, 28(6): 727-733.
[20] Parashis AO, Hawley CE, Stark PC, et al. Prospective Clinical and Radiographic Study of Alveolar Ridge Preservation Combining Freeze‐Dried Bone Allograft With Two Xenogeneic Collagen Matrices [J]. J Periodontal, 2016, 87(4): 416-425.