自体软组织移植辅助前牙即刻种植对唇侧轮廓美学的影响

Aesthetic impact of immediate implantation of anterior teeth with autogenous soft tissue grafting on the lip contour

摘要:

目的 探讨自体软组织移植联合前牙种植对唇侧轮廓美学的影响。方法 回顾性分析2022年7月—2023年6月在大庆油田总医院接受即刻前牙种植治疗的39例单牙种植患者的病历资料。根据治疗方法分为试验组（22例）和对照组（17例）。对照组术后常规覆盖Bio-gide生物膜材料，试验组术后填充自体上下皮结缔组织。术后即刻，比较两组种植体精度、术后创面愈合时间及疼痛分级。术后2周，比较两组龈沟液白细胞介素-6（IL-6）、基质金属蛋白酶-2（MMP-2）水平。术后6个月，比较两组种植体稳定性、红色美学指数（PES）评分、附着龈厚度增量、宽度增量及术后并发症。结果 两组种植体颈部偏差、根尖偏差、角度偏差、种植体稳定性参数、创面愈合时间、术后72 h和1周疼痛分级比较，差异均无统计学意义（P >0.05）。试验组术后即刻和术后3个月、术后即刻和术后6个月、术后即刻和术后12个月PES评分的差值均高于对照组（P <0.05）。试验组术后3个月和术后6个月附着龈厚度增量、附着龈宽度增量均高于对照组（P <0.05）。两组术后即刻和术后2周IL-6、MMP-2的差值比较，差异均无统计学意义（P >0.05）。两组患者术后未出现严重并发症。结论 自体软组织移植辅助前牙种植有助于提高前牙区即刻种植患者术后红色美学效果，促进唇侧软组织轮廓恢复及维持。

Abstract:

Objective To explore the aesthetic impact of immediate implantation of anterior teeth with autogenous soft tissue grafting on the lip contour.Methods A retrospective analysis was conducted on 39 patients undergoing single tooth implant who received immediate implantation of anterior teeth at Daqing Oilfield General Hospital from July 2022 to June 2023. Based on the treatment method, they were divided into an experimental group (22 cases) and a control group (17 cases). In the control group, Bio-Gide was routinely applied after surgery, while the autologous connective tissue grafts were used for postoperative filling in the experimental group. Immediately after surgery, the implant accuracy, postoperative wound healing time and pain levels were compared between the two groups. Two weeks after the surgery, the levels of interleukin-6 (IL-6) and matrix metalloproteinase-2 (MMP-2) in gingival crevicular fluid were compared between the two groups. After 6 months of surgery, the stability of the implant, Pink Esthetic Score (PES), increment of attached gingival thickness and width and postoperative complications were compared between the two groups.Results There were no statistically significant differences between the two groups in terms of implant neck deviation, apical deviation, and angular deviation, ISQs, wound healing time, and pain levels at 72 hours and 1 week postoperatively (P > 0.05). The differences in PES scores between immediately after surgery and 3 months, 6 months, and 12 months postoperatively were higher in the experimental group compared to the control group (P < 0.05). The increment of attached gingival thickness and width at 3 and 6 months after surgery in the experimental group was higher than that in the control group (P < 0.05). The differences in IL-6 and MMP-2 levels between immediately after surgery and 2 weeks after surgery were not different between the two groups (P > 0.05). No severe complications were observed in either group postoperatively.Conclusions Autogenous soft tissue grafting enhances the postoperative pink aesthetic outcomes in implantation of anterior tooth, and promotes the restoration and maintenance of the labial soft tissue contour.