自体骨柱用于前牙美学区早期种植临床效果研究OACSTPCD

Objective To study the clinical effect of early implantation with autogenous bone column in anterior esthetic zone.Methods From January 2018 to January 2020,55 patients with unilateral maxillary anterior tooth loss and hori-zontal bone deficiency who needed guided bone regeneration(GBR)were selected from the Department of Implantology,Dalian Stomatological Hospital.The patients were divided into control group(n=14),autogenous bone group(n=24)and autogenous bone debris group(n=17),and were treated with Bio-Oss® bone powder,autogenous bone combined with Bio-Oss® bone powder,and autogenous bone debris combined with Bio-Oss® bone powder for GBR at the same time of early implantation.The implant survival rate and complications of the three groups were recorded,and the width from the shoulder of the implant neck to the labial bone wall,the width from the 1/2 of the implant surface to the labial bone wall,and the height from the edge of the labial neck(shoulder)to the top of the labial alveolar bone(the high-est coronal point of the labial bone wall)were measured on the day of GBR and 15 months after GBR,and the labi-al bone wall resorption was calculated.The volume of bone increment on the day of GBR and the volume of bone resorption at the 15th month after GBR were measured in the three groups.The pulp vitality of the mesial-distal adjacent teeth in the bone graft area was measured on the 15th month after GBR.The pink and white aesthetic index of the three groups was evaluated on the day of permanent restoration(at the 6th month after bone healing)and at the 15th month after GBR.Results All the implants in the three groups func-tioned normally,the survival rate was 100％,and no complications occurred.At 15 months after GBR,the width from the shoulder of the implant neck to the labial bone wall and the height from the labial neck edge of the implant to the labial alveolar crest in the autogenous bone column group were greater than those in the control group and the autogenous bone debris group,while the bone resorption in the two-dimensional space of the autogenous bone column group was less than that in the control group and the autogenous bone debris group,the differences were statistically significant(all P＜0.05).At the 15th month after GBR,the labial three-dimensional bone volume resorption in the autogenous bone column group and autogenous bone debris group was less than that in the control group,respectively(all P＜0.05).The pulp vi-tality of the proximal and distal adjacent teeth in the graft area was normal at 15 months after GBR.At the 15th month af-ter GBR,the pink-white aesthetic index of the autologous bone column group was higher than that of the control group and the autologous bone debris group,and the differences were statistically significant(P＜0.05).Conclusion The use of Bio-Oss® bone powder in GBR can significantly reduce the amount of bone resorption after adding autogenous bone,and the addition of autogenous bone column is beneficial to maintaining the labial bone mass and restoring the aesthetic contour of the anterior region.