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目的:探讨上前牙美学区拔牙骨量充足者不同种植时机的效果，并探究不同时机种植对牙槽嵴生理吸收及龈沟液基质金属蛋白酶-3（MMP-3）、白介素-1（IL-1）水平的影响。方法:选取2017年5月至2019年7月广州市荔湾区口腔医院128例上前牙美学区拔牙骨量充足患者，采用随机数字表法分为即刻组、延期组，各64例。即刻组男34例、女30例，年龄（30.26±4.62）岁；延期组男29例、女35例，年龄（28.97±4.48）岁。即刻组拔牙后即刻实施种植手术，延期组在拔牙3个月后实施种植手术。比较两组种植成功率、牙槽嵴生理吸收指标［垂直向测量牙槽嵴顶到种植体基台连接处的距离（V）、种植体冠方（C）和中段（M）、种植体根方（A）唇侧骨量变化］、唇侧骨改建、龈沟液MMP-3和IL-1水平。结果:随访期间，即刻组失访2例，延期组失访4例，两组完成随访患者中，即刻组种植体存留率为100.00%（62/62），延期组为100.00%（60/60）；两组均无种植体暴露、松动发生。即刻组种植后12个月牙槽嵴生理吸收指标V、M分别为（1.26±0.41）mm、（0.82±0.33）mm，均大于延期组（0.12±0.10）mm、（1.16±0.28）mm，差异均有统计学意义（均n P＜0.05）。即刻组唇侧骨改建V、M分别为（1.70±0.59）mm、（0.59±0.27）mm，均大于延期组（0.52±0.31）mm、（0.19±0.12）mm，差异均有统计学意义（均n P＜0.05）。种植后6个月、12个月，即刻组龈沟液MMP-3水平分别为（4.20±1.15）μg/L、（4.49±1.13）μg/L，IL-1水平分别为（9.72±2.06）ng/L、（9.81±1.84）ng/L，均低于延期组的（5.31±1.42）μg/L、（5.62±1.24）μg/L及（10.95±1.83）ng/L、（11.16±1.65）ng/L，差异均有统计学意义（均n P＜0.05）。n 结论:拔牙后即刻或延期种植均可取得良好种植效果，拔牙后即刻种植可有效抑制龈沟液MMP-3、IL-1水平的明显升高，且能改善唇侧骨改建。“,”Objective:To explore the effects of different implantation timings on patients with sufficient bone mass undergoing tooth extraction in the aesthetic area of upper anterior teeth, and to investigate the effects of different implantation timings on the physiological absorption of alveolar ridge and the levels of matrix metalloproteinase-3 (MMP-3) and interleukin-1 (IL-1) in the gingival crevicular fluid.Methods:A total of 128 patients with sufficient bone mass undergoing tooth extraction in the aesthetic area of upper anterior teeth in Stomatological Hospital of Liwan District, Guangzhou from May 2017 to July 2019 were selected, and they were divided into an immediate group and a delayed group by the random number table, with 64 cases in each group. In the immediate group, there were 34 males and 30 females, with an age of (30.26±4.62) years old; in the delayed group, there were 29 males and 35 females, with an age of (28.97±4.48) years old. The immediate group underwent implantation surgery immediately after tooth extraction, and the delayed group underwent implantation surgery 3 months after tooth extraction. The successful implantation rate, physiological absorption indexes of alveolar ridge [changes in labial bone mass of vertical measurement of the distance from the top of alveolar ridge to the junction of implant abutment (V), the crown (C) and the middle section (M) of the implant, and the root of the implant square (A)], labial bone remodeling, and the levels of MMP-3 and IL-1 in the gingival crevicular fluid were compared between the two groups.Results:During the follow-up period, 2 patients in the immediate group were lost to follow-up, and 4 patients in the delayed group were lost to follow-up. In both groups of patients who completed the follow-up, the implant survival rate in the immediate group was 100.00% (62/62), and that in the delayed group was 100.00% (60/60); no implant exposure or loosening occurred in both groups. The physiological absorption indexes V and M of alveolar ridge in the immediate group 12 months after the implantation were (1.26±0.41) mm and (0.82±0.33) mm, respectively, which were higher than those in the delayed group [(0.12±0.10) mm and (1.16±0.28) mm], with statistically significant differences (bothn P<0.05). The V and M of labial bone remodeling in the immediate group were (1.70±0.59) mm and (0.59±0.27) mm, respectively, which were higher than those in the delayed group [(0.52±0.31) mm and (0.19±0.12) mm], with statistically significant differences (bothn P<0.05). Six and twelve months after the implantation, the levels of MMP-3 in the gingival crevicular fluid in the immediate group were (4.20±1.15) μg/L and (4.49±1.13) μg/L, the levels of IL-1 were (9.72±2.06) ng/L and (9.81±1.84) ng/L, respectively, which were lower than those in the delayed group [(5.31±1.42) μg/L, (5.62±1.24) μg/L, (10.95±1.83) ng/L, and (11.16±1.65) ng/L], with statistically significant differences (alln P<0.05).n Conclusions:Implanting immediately or delayed after tooth extraction can achieve good implantation results. Implanting immediately after tooth extraction can effectively inhibit significant increase in the levels of MMP-3 and IL-1 in the gingival crevicular fluid, and can improve the labial bone remodeling.