环状植骨术同期牙种植临床效果的短期观察

目的 观察环状植骨术后的临床效果并总结其手术操作要点。方法 15例牙槽骨量严重不足的患者接受环状植骨术并同期植入种植体，术后 5个月后行上部修复。分别于术前和术后 4个月拍摄锥形束 CT，测量牙槽骨增加的高度和唇舌侧骨吸收量。冠修复后 4~6个月对其牙龈附着水平、牙间乳头分级和牙周探诊深度（PD）进行测量分析，统计骨环的成活率及种植体的存留率，同时观察术后并发症并了解患者的满意度。结果 术后 4个月复查，骨环成活率为 94.4%，种植体的存留率为 100%；增加的垂直骨量为（6.06±1.06） mm，骨吸收量为（1.33±0.84） mm；种植体颈部中心唇舌向的骨宽度为（6.94±0.73） mm。冠修复后 4~6个月随访时，增加的垂直骨量为（5.62±1.03） mm，骨吸收量为（1.51±1.02） mm，种植体颈部中心唇舌向的骨宽度为（6.77±0.72） mm。种植牙和邻牙的PD无明显差异（ P>0.05）。术后无明显的并发症，修复效果好，患者满意度高。结论 环状植骨术同期植入种植体，手术操作相对容易，疗程缩短，近期效果可靠，远期效果有待进一步观察。

Short-term evaluation of clinical effect of bone ring grafting and immediate insertion

Objective  To observe the short-term clinical effectiveness of bone ring graft technique and to summarize the key points of related surgical operation to provide comprehensive clinical guidelines. Methods Fifteen patients with severe alveolar bone absorption were selected to receive bone ring grafting and immediate dental implant. Final fixed prostheses were cemented   five  months after initial  implantation. Cone beam CT scans were conducted on all subjects before the procedure,as well as four months post-operation to evaluate alveolar bone height and level of bone height and absorption around the implants. Four to six months after prosthesis installation, each implant’s Jemt classification,gingiva attachment, and probing depth (PD) were analyzed. The difference of PD between implants and adjacent teeth, as well as the difference of the bone absorption between labial and lingual sides, was compared. The survival rate of the bone ring and the retention rate of implants were calculated. Complications and patient satisfaction were also investigated. Results  Bone graft survival rate was 94.4% and dental implantation retention rate was 100% four months post-operation. Average bone level increase was (6.06±1.06) mm, average bone absorption was (1.33±0.84) mm, and average bone thickness at the neck of the dental implant body was(6.94± 0.73) mm. Approximately 4 to 6 months after crown restoration, average bone level increase was (5.62±1.03) mm, average bone absorption was(1.51±1.02) mm, and average bone thickness at the neck of the dental implant body was(6.77±0.72) mm. The PD around the implant body and the adjacent teeth was statistically insignificant. No major post-operative complication was observed, restorations were successful,and patient satisfaction level was high.Conclusion  Bone ring graft technique and immediate dental implantation are relatively simple to perform, and these techniques facilitate reduction in required treatment time. Short-term effectis reliable and satisfactory, whereas long-term outcomes require further follow up and study.