Abstract:

Objective: To analyze the factors influencing labial bone resorption six months after delayed implant placement with simultaneous guided bone regeneration (GBR) in the anterior maxillary region. To explore the impact of the labial bone width at the time of second-stage surgery on marginal bone loss, 1 year after final restoration. Methods: The retrospective cohort study included 57 patients with 94 implants and with a follow-up of 1 year after final restoration. Cone beam CT (CBCT) was used to measure the labial horizontal bone width and vertical bone height of implants immediately after surgery (T1) and six months later (T2). Generalized linear mixed models were employed to analyze the factors affecting horizontal and vertical bone resorption. Implants were categorized into three groups based on labial bone width measured by CBCT six months postoperatively: 0 mm bone wall group, <2 mm bone wall group, and ≥2 mm bone wall group respectively. The impact of labial bone width on marginal bone resorption was explored through one-year follow-up after prosthetic loading. Results: Non-contained defects and implant connection with healing abutments were correlated with less horizontal and vertical bone resorption. Results from the one-year follow-up revealed that there was no significant difference among the three groups. Soft tissue augmentation at implant sites were significantly associated with less marginal bone loss. Conclusion: Six months after GBR, the use of healing abutments and contained defects intraoperatively favored the preservation of horizontal and vertical bone volume. Soft tissue augmentation at implant sites contributed to maintaining stable marginal bone level.

Key words: guided bone regeneration, bone resorption, defect morphology, implant connection, soft tissue augmentation

摘要：

目的: 分析上颌前牙区，延期种植同期进行引导骨再生（guided bone regeneration，GBR）术后6个月唇侧骨吸收的影响因素。探究种植二期手术时种植体唇侧骨宽度对种植体边缘骨吸收的影响。方法: 本研究为回顾性队列研究，随访至最终修复后1年。采用锥形束CT（cone beam CT，CBCT）测量术后即刻（T1）和术后6个月（T2）种植体唇侧水平骨宽度和垂直骨高度，采用广义线性混合模型分析影响因素。根据T2时的唇侧骨宽度，将种植体分为3个队列：0骨壁组、骨壁<2 mm组和骨壁≥2 mm组，探究组间边缘骨吸收差异。结果: 共纳入57例患者，94枚种植体。容纳性骨缺损、种植体连接愈合基台与更少的骨吸收显著相关；在修复后1年的随访中，组间边缘骨吸收差异无统计学意义；种植位点行软组织增量手术与更少的边缘骨丧失显著相关。结论: GBR术中使用愈合基台更有利于维持水平、垂直骨量；软组织增量手术利于维持稳定的边缘骨水平。

关键词: 引导骨再生, 骨吸收, 骨缺损形态, 种植体连接, 软组织增量手术

CLC Number: 

• R782