【摘要】 目的:探讨及评估微创牙种植手术技巧应用在伴系统性疾病老年种植患者中的临床治疗效果。方法:60岁以上伴系统性疾病老年种植患者共分为4组,组1(高血压组)12例、组2(心脏病组)6例、组3(糖尿病组)6例和组4(合并有两种或两种以上疾病)6例,随机将每组患者分别分为实验组(非翻瓣式环切法种植术修复)和对照组(传统翻瓣式种植术修复)。采用全景X线曲面断层和缺牙区根尖X光片进行术前检查,共植入种植体40枚,术后12-16周行永久性修复。对比实验组和对照组手术时间长短;观察、检测术后1d、3d、1周,种植区软组织状况和患者疼痛阈值;测定术前、术后1月、3月、半年和1年的X线牙槽骨改变,作出临床评价。结果:实验组较对照组术后疼痛轻,组织无明显充血水肿等炎性反应,软组织愈合时间短,龈乳头退缩不明显。平均随访时间约为13个月,40枚种植体周围骨质无明显透射阴影区,实验组和对照组术后6个月平均牙槽嵴骨吸收量分为0.14mm和0.16mm。实验组单颗牙种植的平均时间14.5min,对照组29min,两者具有显著性差异(P<0.01)。结论:对伴有系统性疾病的老年种植患者可采用非翻瓣式环切法微创种植术,手术简单,术中时间短,术后反应轻,种植成功率高,患者容易接受。更多还原

【Abstract】 Objective:To observe and evaluate the clinical effection of the mini-invasivly dental implantation used in aged patients with systemic diseases. Methods: Thirty subjects with different systemic diseases aged above 60 years were observed in this research. Fifteen patients(experimental group,EG) were treated with flapless implant surgery using a tissue punch technique,the others (control group,CG) were treated with flap implant surgery. Forty implants placed in the upper and lower were radiographically and clinically measured before operation and 1-,3-,6-,12-month after operation respectively.The peri-implant bone and soft tissue of 40 implants in 30 subjects were evaluated by conventional radiology and orthopanotomography. Results: Of the 30 patients originally treated,all patients and implants were followed up for a mean time of 13 months. None of 40 implants failed within the period.The pain of soft tissue in the EG was less than in the CG in the first week after implant placement.The average operation-time was 14.5 min in the EG and 29 min in the CG.Peri-implant bone levels were stable within the 13-month period following implant placement.The change in marginal bone levels after 1 year were 0.14 mm in EG and 0.16 mm in CG. Conclusion: Flapless implant surgery using a tissue punch technique can be used in the aged with systemic diseases, and it has a good successful rate and compliance rate.更多还原