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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。
Objective: To investigate and evaluate the clinical effect of minimally invasive dental implants in elderly patients with systemic diseases. Methods: Elderly patients with systemic diseases over 60 years old were divided into 4 groups: group 1 (hypertensive group), group 6 (group 2), group 3 (group 6) and group 4 Combined with two or more diseases) in 6 cases. The patients in each group were randomly divided into experimental group (non-flap revascularization) and control group (traditional flap flap implant repair). A total of 40 implants were implanted with panoramic X-ray surface and root-tip radiographs of edentulous area. Twelve to 16 weeks postoperatively, permanent repairs were performed. The duration of operation was compared between the experimental group and the control group. The soft tissue condition and the patient's pain threshold at 1 day, 3 days and 1 week after operation were observed and measured. The changes of X-ray before and 1 month, 3 months, 6 months and 1 year Alveolar bone change, make a clinical evaluation. Results: Compared with the control group, the experimental group had less postoperative pain, no inflammatory reaction such as hyperemia and edema in the tissue, short healing time of soft tissue and no obvious regression of the papilla. The mean follow-up time was about 13 months. There was no obvious transmission shadow area around the 40 implants. The mean alveolar ridge bone resorption in experimental group and control group at 6 months after operation was 0.14 mm and 0.16 mm, respectively. The mean time of single tooth implantation in experimental group was 14.5min, while that in control group was 29min, there was significant difference (P <0.01). CONCLUSIONS: Non-flap revascularization minimally invasive implants can be used for elderly patients with systemic diseases. The operation is simple, the time is short, the postoperative reaction is light, the implantation rate is high, and the patients are easy to accept.