不同种植体植入方法与牙槽嵴顶垂直向黏膜厚度变化的研究分析

doi:10.13591/j.cnki.kqyx.2025.08.007

摘要/Abstract

摘要：

目的分析不同黏膜厚度下不同种植体植入方法与牙槽嵴顶垂直向黏膜厚度变化之间的关系。方法选取2022年6—12月后牙缺失患者98例,共植入120颗种植体,其中薄龈组(牙龈厚度<3 mm)90颗与厚龈组(牙龈厚度≥3 mm)30颗。以30颗厚龈常规平骨植入组作为对照,对薄龈病例采用3种不同的手术方式进行Ⅰ期种植,其中A组32颗采用植入前牙槽嵴修整方法,B组30颗采用骨下植入种植体方法,C组28颗采用帐篷技术方法,分析种植Ⅰ期手术前和3~4个月骨结合后牙槽嵴顶垂直向黏膜厚度变化。结果薄龈组经A、B、C 3种不同处理方法处理形成骨结合后,牙龈厚度由H_a(1.96±0.35)mm、H_b(1.89±0.42)mm、H_c(1.96±0.29)mm分别增加至H'_a(2.88±0.23)mm、H'_b(2.93±0.30)mm、H'_c(2.65±0.22)mm。三组薄龈型牙槽嵴顶垂直向黏膜厚度较Ⅰ期术前均有明显增加(P<0.05),其中A、B组增加量(增厚约1 mm)稍高于C组(增厚约0.6 mm),而对照组H_d(3.60±0.24)mm与H'_d(3.36±0.47)mm则未见统计学差异(P>0.05)。此外,术中牙龈厚度测量值(H_a、H_b、H_c、H_d)与CBCT影像学测量结果(H_A、H_B、H_C、H_D)基本一致,未见统计学差异(P>0.05)。结论在种植手术前仔细测量牙槽嵴顶垂直向黏膜厚度,并据此选用不同的植入方法将种植体植入到合适位置,能在一定程度上起到增厚牙槽嵴顶垂直向软组织厚度的作用,进而有助于维持种植体周围骨稳定,提高种植体成功率。

关键词: 牙槽嵴顶, 黏膜厚度, 生物学宽度, 厚龈型, 薄龈型

Abstract:

Objective To analyze the relationship between implant placement methods and the change of alveolar crest mucosal thickness under different gingival thickness. Methods A total of 98 patients with posterior tooth loss from June 2022 to December 2022 were selected, and a total of 120 implants were implanted. There were 90 samples in the thin gingiva group (gingiva thickness <3 mm) and 30 samples in the thick gingiva group (gingiva thickness≥3 mm). For the thin gingival cases, three different surgical methods were used for one-stage implantation. Group A (32 teeth) received ridge trimming before implantation. In group B, 30 implants were placed under the bone. In group C, 28 teeth used tent technique to analyze the vertical soft tissue thickness changes of alveolar crest before and 3~4 months after osseointegration. Results The thin gingival group was treated with three different treatments A, B and C. The gingival thickness increased from H_a(1.96±0.35)mm, H_b(1.89±0.42)mm, H_c(1.96±0.29)mm to H'_a(2.88±0.23)mm, H'_b(2.93±0.30)mm, H'_c(2.65±0.22)mm, respectively. The alveolar crest vertical mucosal thickness of the three groups increased significantly (P<0.05). The increase in group A and B (about 1 mm) was slightly higher than that in group C (about 0.6 mm), while there was no significant difference between the control group H_d(3.60±0.24)mm and H'_d(3.36±0.47)mm (P>0.05). In addition, the intraoperative gingival thickness measurements (H_a, H_b, H_c, H_d) were basically consistent with the CBCT imaging measurements (H_A, H_B, H_C, H_D), and there was no significant difference (P>0.05). Conclusion Careful analysis of the vertical thickness of the alveolar crest to the mucosa before implant surgery and selection of different implantation methods can increase the vertical thickness of the alveolar crest to the appropriate position, thereby maintaining the stability of the bone around the implant and improving the success rate of the implant.

Key words: alveolar crest, mucosal thickness, biological width, thick gingival type, thin gingival type

中图分类号:

R783.4

窦晨云, 沈文静, 王金梅, 李贝贝, 甄朋龙, 孟令强. 不同种植体植入方法与牙槽嵴顶垂直向黏膜厚度变化的研究分析[J]. 口腔医学, 2025, 45(8): 603-607.

DOU Chenyun, SHEN Wenjing, WANG Jinmei, LI Beibei, ZHEN Penglong, MENG Lingqiang. Analysis of different implant implantation methods and changes of alveolar crest vertical membrane thickness[J]. Stomatology, 2025, 45(8): 603-607.

图/表 3

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分布	直径3.3 mm			直径4.1 mm			直径4.8 mm			上颌	下颌
分布	8 mm	10 mm	12 mm	8 mm	10 mm	12 mm	8 mm	10 mm	12 mm	上颌	下颌
前磨牙	6	9	6	4	10	4	1	2	0	18	24
磨牙	8	13	4	1	14	13	1	14	10	23	55

组别	n	术前(CBCT影像学测量)	Ⅰ期手术中	3~4个月后	t^*	P^*	垂直向黏膜厚度变化
A组	32	1.87±0.27	1.96±0.35	2.88±0.23	-15.35	0.00	0.93±0.23
B组	30	1.88±0.25	1.89±0.42	2.93±0.30	-13.55	0.00	1.03±0.31
C组	28	2.06±0.35	1.96±0.29	2.65±0.22	-19.99	0.00	0.68±0.34
D组	30	3.48±0.17	3.60±0.24	3.36±0.47	1.97	0.07	-0.23±0.36