中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (20): 3641-3645.doi: 10.3969/j.issn.1673-8225.2010.20.008

• 口腔组织构建 oral tissue construction • 上一篇    下一篇

即刻种植同期行软组织处理对种植体周围软组织形态的影响

郭力强1，郑 军2，刘 沂1，许家森1，赵保东1   

  1. 1青岛大学医学院附属医院，山东省青岛市266003；
    2胜利油田管理局河口医院，山东省东营市272500
  • 出版日期:2010-05-14 发布日期:2010-05-14
  • 通讯作者: 赵保东，硕士生导师，主任医师，青岛大学医学院附属医院东区口腔科，山东省青岛市 266003 zbd315@sina.com
  • 作者简介:郭力强，男，1983年生，山东省泰安市人，青岛大学医学院在读硕士，汉族，主要从事口腔颌面外科研究。 glq2312@163.com

Effects of immediate implant combined with disposal of soft tissues on morphology of peri-implant soft tissues

Guo Li-qiang1, Zheng Jun2, Liu Yi1, Xu Jia-sen1, Zhao Bao-dong1   

  1. 1The Affiliated Hospital of Medical College, Qingdao University, Qingdao  266003, Shandong Province, China;
    2Hekou Hospital of Shengli Petroleum Administration Bureau, Bureau Dongying  272500, Shandong Province, China
  • Online:2010-05-14 Published:2010-05-14
  • Contact: Zhao Bao-dong, Master’s supervisor, Chief physician, the Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China zbd315@sina.com
  • About author:Guo Li-qiang, Studying for master’s degree, the Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China glq2312@163.com

PDF

490

被引次数

23

摘要：

背景：即刻牙种植关闭创口时，由于顶端附着龈的缺损，常用唇侧黏骨膜瓣滑行、自体游离龈组织移植、异种脱细胞真皮基质移植和二段式种植体一次手术法等对种植体周围软组织进行处理。但目前的研究仅限于临床病例报道，缺少相关动物实验的研究证据。
目的：建立即刻种植动物模型，分析唇侧黏骨膜瓣滑行、异种脱细胞真皮基质移植、自体游离龈组织移植和二段式种植体一次手术法对种植体周围软组织形态的影响。
方法：健康成年杂种犬全麻后拔除下颌双侧第二、四前磨牙，即刻植入BLB种植体。根据手术方式分为4组，唇侧黏骨膜瓣滑行组、自体游离龈瓣移植组、异种脱细胞真皮基质移植组和二段式种植体一次手术组。3个月后，唇侧黏骨膜瓣滑行组、自体游离龈瓣移植组、异种脱细胞真皮基质移植组行二期手术；2周后烤瓷冠修复，负荷1个月后处死动物，制作带牙周组织的硬组织磨片并进行组织形态学分析。手术前、后均测量各组的龈沟探诊深度、牙龈指数、附着龈宽度等指标进行统计学分析。
结果与结论：所有种植体周围软组织均愈合良好。种植体-软组织界面可以形成和天然牙周类似的结合上皮结构。唇侧黏骨膜瓣滑行组由于破坏了种植体周围软组织解剖结构，修复效果较差；自体游离龈瓣移植、异种脱细胞真皮基质移植和二段式种植体一次手术法可有效关闭软组织创口，不影响周围软组织形态；所有组龈沟探诊深度术前后无明显变化，所有组负荷1个月后的牙龈指数均高于术前(P < 0.05)，唇侧黏骨膜瓣滑行组负荷1月后附着龈宽度较术前明显降低(P < 0.001)。结果表明即刻种植同期进行适当的软组织处理方法可以取得较好的种植美学修复效果。

关键词: 牙种植体, 即刻种植, 动物模型, 滑行黏骨膜瓣, 游离龈瓣, 异种脱细胞真皮基质, 口腔组织工程

Abstract:

BACKGROUND: Due to top attached gingival defect, labial slipping mucoperiosteum flaps, free gingival flaps, acellular dermal matrix (ADM) and one-stage surgery of two-stage implants were used after immediate implant to close the soft tissue defect. However, the current study is limited to clinical case report, and relevant research and analysis of animal experimentation is absented.
OBJECTIVE: To establish animal models and to explore the influence of labial slipping mucoperiosteum flaps, free gingival flaps, ADM and one-stage surgery of two-stage implants disposals on morphology of peri-implant soft tissues.
METHODS: Healthy adult dogs were selected. Their second, fourth premolars of mandibles were extracted, and BLB implants were placed immediately into the sockets of the mesial or distal roots by means of self-comparing. Four groups, including slipping mucoperiosteum flaps, free gingival flaps, ADM, and one-stage surgery were divided according operation. The second stage operation was performed in the former three groups at 3 months later. PFM crowns were fixed in each group 2 weeks later. After making ground section of bone with dental implant, histological observation was researched. Before extraction and after 1 month loaded, the probing depth of gingival groove, indexes of gingiva and width of attached gingiva were measured for statistical analysis in each group.
RESULTS AND CONCLUSION: Soft tissues of each group had good healing. The junctional epithelium, which was similar to the natural periodontal structure, could be seen at the implant-soft tissue interface. The slipping mucoperiosteum flaps group got poor outcomes due to the damage of peri-implant soft tissues. The other disposals could effectively close the wound and had no effects on peri-implant soft tissues. The probing depth had no obviously changed prior to and after operation in all groups, but the gingiva indexes were significantly increased at 1 month after operation (P < 0.05), and the width of attached gingiva of the slipping mucoperiosteum flaps group was dramatically decreased after operation (P < 0.001). The technology of disposal of soft tissue on immediate implants was feasible.

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