根盾技术和不翻瓣即刻种植在不同牙龈生物型的种植美学比较

doi:10.13591/j.cnki.kqyx.2023.04.008

Abstract

Abstract:

Objective To compare the esthetics and clinical outcomes in different gingival biotypes between immediate implant placement(IIP) using the conventional flap-less approach and the socket-shield technique(SST). Methods Thirty patients with maxillary anterior tooth and corresponding indications that needed immediate implant and restoration were enrolled. Selected patients(n=30) were randomly allocated to two equal groups for modified immediate implant with SST(n=15) and conventional flap-less immediate implant(n=15). Then according to the visibility of the periodontal probe, the patients were divided into thin gingival and thick gingival biotype. The patients received provisional crown immediately after surgery and definitive restoration 4 months later. Twelve months after the restoration, the patients were revisited for clinical examination. The esthetic outcomes were evaluated by pink esthetic scores(PES) assessment and model analysis including the position of gingival margin and labial contour alternation. Clinical parameters, including the modified sulcus bleeding index(mSBI) was assessed. Postoperative complications and patient satisfaction were also analyzed. Results Twelve months after surgery, all the implants survived. Labial contour alteration were (-0.49±0.18)mm in IIP group and (-0.21±0.18)mm in SST group(P<0.05).For patients with thin gingival biotype, it was (-0.58±0.17)mm in IIP group, and (-0.20±0.19)mm in SST group(P<0.05). The recession of gingival margin reached (-0.76±0.22)mm in IIP group, and (-0.41±0.12)mm in SST group. For patients with thin gingiva, it was (-0.82±0.23)mm in IIP group, and (-0.20±0.19)mm in SST group(P<0.05). PES of IIP group was 10.47±1.15 and SST group was 11.87±0.81. For thin gingival biotype, PES of IIP was 9.78±0.92 and SST was 12.01±0.85 (P<0.05). However. there was no statistical significance for patients with thick gingival biotype. The results of peri-implant exploration showed decreased mSBI values in SST group. Patients in all groups were satisfied with the final esthetic effects. Conclusion SST could significantly improve the esthetic outcome of immediate implant crown by maintaining the contour of alveolar ridge, the gingival margin and the quality of peri-implant tissue, especially for patients with thin gingival biotype.

Key words: socket-shield technique, immediate implant placement, gingival biotype, anterior tooth aesthetics

CLC Number:

R783.4

ZHU Mengfei,LIU Xin,TANG Xuyan. Comparison of the esthetics in different gingival biotypes between the socket-shield technique and the flap-less immediate implant[J]. Stomatology, 2023, 43(4): 327-333.

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References 34

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牙龈生物型	白色	绿色	蓝色
薄	可见	可见	可见
中等	不可见	可见	可见
厚	不可见	不可见	可见
很厚	不可见	不可见	不可见

组别	牙龈生物型		种植体直径
组别	厚	薄	3.5 mm	4.3 mm
IIP(n=15)	6(40.0)	9(60.0)	8(53.3)	7(46.7)
SST(n=15)	4(26.7)	11(73.3)	6(40.0)	9(60.0)
P	0.139		0.715

分组	唇侧轮廓突度变化/mm			唇侧龈边缘变化/mm			PES
分组	厚	薄	合计	厚	薄	合计	厚	薄	合计
IIP	-0.36±0.13	-0.58±0.17	-0.49±0.18	-0.63±0.16	-0.82±0.23	-0.76±0.22	11.50±0.50	9.78±0.92	10.47±1.15
SST	-0.22±0.21	-0.20±0.19	-0.21±0.18	-0.45±0.17	-0.20±0.19	-0.41±0.12	11.25±1.47	12.01±0.85	11.87±0.81
P	0.238	<0.001	<0.001	0.142	<0.001	<0.001	0.765	<0.001	0.002

Comparison of the esthetics in different gingival biotypes between the socket-shield technique and the flap-less immediate implant

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