上颌单颗前牙即刻种植与延期种植修复的美学效果比较

doi:10.19439/j.sjos.2025.04.008

摘要/Abstract

摘要： 目的：比较上颌单颗前牙即刻种植修复与延期种植修复的美学效果。方法：选择2020年1月—2023年5月泰康仙林鼓楼医院收治的上颌单颗前牙种植修复患者163例,根据治疗方式分为即刻种植修复组（75例）和延期种植修复组（88例）。即刻种植修复组在拔牙后立即进行种植并安装临时修复体,延期种植修复组则在拔牙3~6个月后进行种植,并在种植体稳定后进行修复。通过种植成功率、软组织美学度、种植体稳定度、美学效果、牙周组织健康程度、粉红美学评分（pink esthetic score,PES）和白色美学评分（white esthetic score,WES）、术后12个月骨吸收及主观满意度对两组患者的修复效果进行比较。结果：即刻种植修复组62例和延期种植修复组64例患者纳入分析,两组成功率均为100%,无显著差异（P>0.05）。在软组织美学度和种植体稳定度方面,即刻种植修复组显著优于延期种植修复组（P<0.05）。在美学效果比较中,即刻种植修复组在术后1、3、6和12个月的评分显著高于延期种植修复组（P<0.05）。即刻种植修复组的牙周组织健康程度显著优于延期种植修复组（P<0.05）,即刻种植修复组PES和WES评分显著优于延期种植修复组（P<0.05）。术后12个月,即刻种植修复组骨吸收显著低于延期种植修复组,主观满意度评分显著高于延期种植修复组（P<0.05）,色泽满意度两组无显著差异（P>0.05）。结论：上颌单颗前牙即刻种植修复在软组织美学效果、种植体稳定度及患者满意度方面优于延期种植修复,适合于对美学要求较高的患者。

关键词: 即刻种植修复, 延期种植修复, 上颌单颗前牙, 美学, 满意度

Abstract: PURPOSE: To compare the aesthetic effects of immediate implant restoration and delayed implant restoration of single maxillary anterior tooth. METHODS: A total of 163 patients who underwent single anterior tooth implantation in the maxilla at Taikang Xianlin Drum Tower Hospital from January 2020 to May 2023 were selected. They were divided into immediate implant restoration group(n=75) and delayed implant restoration group(n=88). In the immediate implant restoration group, a temporary implant was installed and implanted immediately after extraction, while in the delayed implant restoration group, the implant was implanted 3-6 months after extraction and repaired after the implant was stabilized. The outcomes, including implant success rate, soft tissue aesthetics, implant stability, aesthetic outcomes, periodontal health, pink esthetic score (PES), white esthetic score (WES), bone resorption after 12 months and subjective satisfaction were compared between the two groups. RESULTS: After exclusion, totally 62 patients in the immediate implant restoration group and 64 patients in the delayed implant restoration group were included in the analysis. Both groups had a 100% implant success rate with no significant difference between the two groups(P>0.05). The immediate implant restoration group was significantly better in terms of soft tissue aesthetics and implant stability compared to the delayed implant restoration group(P<0.05). Aesthetic effect scores for the immediate implant restoration group were significantly higher than those of the delayed group at 1, 3, 6 and 12 months postoperatively(P<0.05). The periodontal tissue health of the immediate implant restoration group was significantly better than that of the delayed group at various time points(P<0.05). PES and WES scores of immediate implant restoration group were significantly better than those of the delayed group(P<0.05). At 12 months after surgery, bone resorption in the immediate implant restoration group was significantly lower than that in the delayed group, subjective satisfaction score was significantly higher than that in the delayed group(P<0.05), and there was no significant difference in color satisfaction between the two groups(P>0.05). CONCLUSIONS: Immediate implant restoration of maxillary single anterior teeth is superior to delayed implant restoration in soft tissue aesthetic effect, implant stability and patient satisfaction, which is suitable for patients with high aesthetic requirements.

Key words: Immediate implant restoration, Delayed implant restoration, Maxillary single anterior tooth, Esthetics, Satisfaction

中图分类号:

R783.4

刘秉尧, 俞越, 吴莹莹, 何懋典, 张方琪. 上颌单颗前牙即刻种植与延期种植修复的美学效果比较[J]. 上海口腔医学, 2025, 34(4): 387-391.

Liu Bingyao, Yu Yue, Wu Yingying, He Maodian, Zhang Fangqi. Comparison of aesthetic effect between immediate and delayed implant restoration of single maxillary anterior tooth[J]. Shanghai Journal of Stomatology, 2025, 34(4): 387-391.

参考文献

[1] MacBeth ND, Donos N, Mardas N. Alveolar ridge preservation with guided bone regeneration or socket seal technique. a randomised, single-blind controlled clinical trial[J]. Clin Oral Implants Res, 2022, 33(7): 681-699.
[2] Winitsky N, Naimi-Akbar A, Nedelcu R, et al.3-D tooth movement adjacent to single anterior implants and esthetic outcome. a 14- to 20-year follow-up study[J]. Clin Oral Implants Res, 2021, 32(11): 1328-1340.
[3] 黄建生, 周磊, 宋光保. 前牙美观区单牙即刻种植修复[J]. 上海口腔医学, 2003, 12(3): 174-177.
[4] Patel R, Ucer C, Wright S, et al.Differences in dental implant survival between immediate vs. delayed placement: a systematic review and meta-analysis[J]. Dent J (Basel), 2023, 11(9):218.
[5] Yu X, Teng F, Zhao A, et al.Effects of post-extraction alveolar ridge preservation versus immediate implant placement: a systematic review and meta-analysis[J]. J Evid Based Dent Pract, 2022, 22(3):101734.
[6] Zuiderveld EG, Meijer HJA, Gareb B, et al.Single immediate implant placement in the maxillary aesthetic zone with and without connective tissue grafting: results of a 5-year randomized controlled trial[J]. J Clin Periodontol, 2024, 51(4):487-498.
[7] 吕晓蕾, 史俊宇, 钱姝娇, 等. 上颌前牙美学区单颗种植修复体应用角度螺丝通道系统基台和预成钛基台的短期临床疗效比较[J]. 上海口腔医学, 2022, 31(4): 423-428.
[8] 裘实, 罗畅, 蔡安庆, 等.个性化牙龈成型器在不同牙龈生物型及角化龈宽度患者上颌单颗前牙种植中的应用效果[J].中国口腔颌面外科杂志, 2024, 22(4):378-384.
[9] 李伟, 张志宏, 边华琴, 等. 即刻与延期前牙种植义齿修复的临床效果及主观满意度调查[J]. 重庆医学, 2015, 44(8): 1103-1105.
[10] Vetromilla BM, Brondani LP, Pereira-Cenci T, et al.Influence of different implant-abutment connection designs on the mechanical and biological behavior of single-tooth implants in the maxillary esthetic zone: a systematic review[J]. J Prosthet Dent, 2019, 121(3): 398-403.
[11] Kern M, Passia N, Sasse M, et al.Ten-year outcome of zirconia ceramic cantilever resin-bonded fixed dental prostheses and the influence of the reasons for missing incisors[J]. J Dent, 2017, 65: 51-55.
[12] Slagter KW, Raghoebar GM, Hentenaar DFM, et al.Immediate placement of single implants with or without immediate provisionalization in the maxillary aesthetic region: a 5-year comparative study[J]. J Clin Periodontol, 2021, 48(2):272-283.
[13] Riachi E, Juodzbalys G, Maciuliene D.Clinical outcomes of immediate, early, and delayed implant placement in the esthetic zone: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Implants, 2024, 39(5):157-173.
[14] Carpentieri J, Greenstein G.Guidelines for immediate vs delayed dental implant placement in the esthetic zone[J]. Compend Contin Educ Dent, 2024, 45(7):340-347.
[15] Donos N, Asche NV, Akbar AN, et al.Impact of timing of dental implant placement and loading: summary and consensus statements of group 1-The 6th EAO Consensus Conference 2021[J]. Clin Oral Implants Res, 2021, 32(Suppl 21):85-92.
[16] Al-Aroomi OA, Sakran KA, Al-Aroomi MA, et. Immediate implant placement with simultaneous bone augmentation versus delayed implant placement following alveolar ridge preservation: a clinical and radiographic study[J]. J Stomatol Oral Maxillofac Surg, 2023, 124(1S):101291.
[17] Bhuvaneshwari S, Priyaranjan, Singh J, et al.A Comparative assessment of peri-implant soft and hard tissues with immediate and delayed implants[J]. J Contemp Dent Pract, 2020, 21(11):1249-1252.
[18] Yu X, Teng F, Zhao A, et al.Effects of post-extraction alveolar ridge preservation versus immediate implant placement: a systematic review and meta-analysis[j]. J Evid Based Dent Pract, 2022, 22(3):101734.
[19] Saleh Hasani Jebelli M, Yari A, Nikparto N, et al. Tissue engineering innovations to enhance osseointegration in immediate dental implant loading: a narrative review[J]. Cell Biochem Funct, 2024, 42(2):e3974.
[20] Cosyn J, De Bruyn H, Cleymaet R.Soft tissue preservation and pink aesthetics around single immediate implant restorations: a 1-year prospective study[J]. Clin Implant Dent Relat Res, 2013, 15(6): 847-855.
[21] Naldini P, Torassa D, Calvo-Guirado JL,et al.Evaluation of contour augmentation in immediate single-tooth implants with and without flaps in the anterior maxilla: a 1-year prospective study[J]. Int J Periodontics Restorative Dent, 2022, 42(3): 331-339.
[22] Elbrashy A, Osman AH, Shawky M, et al.Immediate implant placement with platelet rich fibrin as space filling material versus deproteinized bovine bone in maxillary premolars: a randomized clinical trial[J]. Clin Implant Dent Relat Res, 2022, 24(3):320-328.
[23] 周宏志, 贺平, 赵军, 等. 不同骨缺损条件下的即刻与延期种植修复的临床应用评价[J]. 口腔医学研究, 2008, 24(6): 685-687.
[24] 肖慧娟, 杨云东, 施斌, 等. 种植体即刻负重或早期负重与延期负重相比对种植体成功率影响的meta分析[J]. 中国循证医学杂志, 2008, 8(2): 120-126.
[25] 谢艳婷, 江鹭鹭, 何晶, 等. 美学区单颗牙即刻种植和延期种植的短期红色美学和种植体边缘骨吸收的临床效果比较及影响因素分析[J]. 上海口腔医学, 2019, 28(2): 148-153.