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彭敏, MANDANA Hosseini, 张丰雪. 上中切牙种植修复中种植体位置对临床冠长和龈乳头丰满度的影响[J]. koko体育app 学报(医学版), 2018, 49(4): 656-659.
引用本文: 彭敏, MANDANA Hosseini, 张丰雪. 上中切牙植入牙休复中植入牙体定位对临床实践冠长和龈奶头性感丰满度的的影响[J]. 广东综合大学学报(医学界版), 2018, 49(4): 656-659.
PENG Min, MANDANA Hosseini, ZHANG Feng-xue. Effects of Implant Position on Clinical Crown Length and Papilla Fills in Implant-supported Maxillary Central Incisors[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(4): 656-659.
Citation: PENG Min, MANDANA Hosseini, ZHANG Feng-xue. Effects of Implant Position on Clinical Crown Length and Papilla Fills in Implant-supported Maxillary Central Incisors[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(4): 656-659.

上中切牙种植修复中种植体位置对临床冠长和龈乳头丰满度的影响

Effects of Implant Position on Clinical Crown Length and Papilla Fills in Implant-supported Maxillary Central Incisors

  • 摘要: 目的 评价上中切牙种植单冠修复中种植体位置对临床冠长和龈乳头丰满度的影响。 方法 纳入158例因外伤导致上颌中切牙(11或21)缺失后进行种植支持式单冠修复的患者,以对侧天然牙为对照。拍摄患者种植冠技工模型的标准图片和种植冠戴牙后首次复诊的口内片及根尖周片,测得种植体各三维位置参数及龈乳头长度。配对t检验用于比较种植冠与对照天然牙的临床冠长及近中、远中龈乳头丰满度,种植冠近中、远中牙槽嵴高度和植体肩台参考平面上植体与天然牙间的近中、远中水平距离。Pearson相关检验用于分析种植体各位置参数与冠长差异和龈乳头丰满度的相关性。 结果 种植单冠的临床冠长长于对照天然牙(10.9±1.1)mm vs.(10.4±0.8)mm,P<0.05,冠长差异为(0.3±0.7)mm。种植冠近中龈乳头和对照天然牙远中龈乳头均较种植冠远中位点更丰满(P<0.000 1)。种植冠近中牙槽嵴高度较远中牙槽嵴高(2.2±1.4)mm vs.(1.2±1.5)mm,P<0.05。种植体的唇腭向植入位置与冠长差异呈正相关(r=0.602,P=0.001)。种植体与缺牙区邻牙唇面凸点所在平面的矢状夹角、植体肩台和邻牙颈缘连线间垂直距离与冠长差异均无相关性。种植冠牙槽嵴高度与龈乳头丰满度间呈正相关(r=0.400,P=0.001)。 结论 种植体植入位点偏唇侧可导致种植冠临床冠长长于对照天然牙。种植体植入唇倾角度较小时可在修复时用常规角度基台加以修正,不会影响临床冠长。通过调整植入位点和深度或可避免牙槽嵴吸收并改善龈乳头丰满度。  
    Abstract: Objective To determine the effect of implant position on clinical crown length and papilla fills in implant-supported maxillary central incisors. Methods One implant replacing the 11th or 21st tooth was given to 158 patients who lost a maxillary central incisor after trauma. The contra-lateral central incisors were used as controls. The three-dimensional positional parameters were estimated using standardized photographs of the cast models, clinical photographs and peri-apical radiographs. Paired t tests were performed to examine the differences between the implants and the control teeth in clinical crown length, papilla fills, proximal bone crest levels, and the horizontal implant-teeth distance at the mesial and distal implant. Pearson correlations were used to identify the implant positional parameters associated with crown length and papilla fills. Results The implant-supported crowns were statistically longer than the controls(10.9±1.1) mm vs. (10.4±0.8) mm, P<0.05. Greater papilla fills were found in the mesial implants and distal contra-lateral teeth compared with the distal implants (P<0.000 1). The implants had higher levels of mesial proximal bone crest than the distal(2.2±1.4) mm vs. (1.2±1.5) mm, P<0.05. The oro-facial position of the implants was associated with the crown length (r=0.602, P=0.001). But the crown length was not correlated with the sagital angulation of the implants or the vertical distance from the implant fixture to the soft tissue margin. The proximal bone crest level was correlated with the papilla fill height (r=0.400,P=0.001). Conclusions An implant positioned buccally results in longer crown length. Minor buccal angulations of the implant do not necessarily result in increased crown length. Appropriate position and input depth may help avoid bone absorption and papilla shrinkage.  
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