引导骨再生对种植体周围软组织炎症易感性的影响

doi:10.13701/j.cnki.kqyxyj.2023.08.010

摘要/Abstract

摘要： 目的: 通过分析下颌后牙区植入在引导骨再生区域种植体的临床检查指标以及龈沟液内炎症因子和蛋白酶量,评估牙槽嵴水平向植骨对种植体周围软组织的长期稳定和炎症易感性的影响,并将其与常规种植的种植体相比较。方法: 选取负荷12~24个月并且颊侧角化龈宽度≥2 mm的软组织水平种植体共62颗,其中下颌后牙区水平向GBR植骨术(可吸收胶原膜结合1∶1的自体骨颗粒与异种骨替代材料)后,种植固定修复的患者12例,共27颗种植义齿(实验组);下颌后牙区使用相同系统种植体行常规种植手术的患者16例,共35颗种植义齿(对照组)。对种植体临床检查并记录探诊深度、改良菌斑指数、改良龈沟出血指数;使用相同规格滤纸条采集所有种植体周围龈沟液,同时采集1颗健康对照天然牙。通过ELISA实验定量检测IL-1β、IL-6、TNF-α、MMP-8浓度。结果: 两组患者种植体负荷12~24个月后生存率均为100%。平均负荷(18.70±4.45)个月后,实验组种植义齿PD小于对照组(P＜0.05),而mSBI、mPLI在两组之间没有明显差异(P＞0.05)。两组种植体之间及其与健康天然牙间各项细胞因子含量均无明显差异(P＞0.05)。结论: 通过使用1∶1自体骨/异种骨混合移植的水平向引导骨再生技术获得了良好的临床效果。引导骨再生植骨术未对种植体周围软组织的稳定性和炎症易感性有明显影响。

关键词: 下颌后牙区, 引导骨再生, 1∶1自体骨/异种骨混合移植, 炎症因子, 炎症易感性

Abstract: Objective: To evaluate the effect of guided bone regeneration (GBR) on the long-term stability and inflammatory susceptibility of soft tissues around the implants. Methods: A total of 62 soft tissue level implants with keratinized gingival width ≥2 mm were selected for 12-24 months. After horizontal GBR (absorbable collagen membrane combined with 1∶1 autogenous bone and xenogenous bone replacement materials), 12 patients with 27 implant dentures were implanted and fixed (experimental group). There were 16 patients with the same system of implants in the mandibular posterior area undergoing routine implant operation, with a total of 35 implants (control group). Clinical indexes of implants were examined and the probing depth, modified plaque index, and modified sulcus bleeding index were recorded. Gingival crevicular fluid around all implants and a healthy control natural tooth were collected using the same filter strip. ELISA was used to detect the content of IL-1β, IL-6, TNF-α, MMP-8 . Results: The survival rates of both groups after 12-24 months of loading were 100%. After an average load of (18.70±4.45) months, PD of the experimental group was lower than that of the control group (P<0.05), while there was no significant difference in mSBI and mPLI between two groups (P>0.05). There were no significant differences in the contents of various cytokines between two groups and between the implants and healthy natural teeth (P>0.05). Conclusion: GBR with 1∶1 autogenous bone/xenograft had no significant effect on the stability and inflammatory susceptibility of the soft tissue around the implant.

Key words: mandibular posterior region, guided bone regeneration, 1∶1 autogenous bone/allogeneic bone mixed graft, inflammatory factor, inflammatory susceptibility

姜兆霞, 孔德婧, 李雨萱, 刘明丽, 曲哲. 引导骨再生对种植体周围软组织炎症易感性的影响[J]. 口腔医学研究, 2023, 39(8): 715-720.

JIANG Zhaoxia, KONG Dejing, LI Yuxuan, LIU Mingli, QU Zhe. Effect of Guided Bone Regeneration on Inflammatory Susceptibility of Peri-implant Soft Tissue[J]. Journal of Oral Science Research, 2023, 39(8): 715-720.

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