两种固位方式下种植义齿周围组织情况及菌群分布的比较研究

摘要

目的：比较粘接固位与螺丝固位种植义齿修复后周围组织的健康情况及龈下菌群分布的差异。方法上下颌牙列缺损患者36例共68枚种植体，其中31枚采用螺丝固位修复体，37枚采用粘接固位修复体。分别于修复后第3个月、6个月、12个月复诊，检测种植义齿探诊深度（PD）、改良菌斑指数（mPLI）、改良出血指数（mSBI）等临床指标，比较种植体周围软组织健康状况，测量种植体边缘骨吸收（MBL）状况。采集种植体龈下菌群标本，比较两种固位方式修复后龈下菌群的差异。结果两组的mPLI、mSBI、PD、MBL在所有时间点差异均无统计学意义。在第3个月，螺丝固位组的种植义齿龈下厌氧菌总数高于粘接固位组（P<0.05）。在第6个月，螺丝固位组种植义齿龈下具核梭杆菌总数高于粘接固位组（P<0.05）。12个月时，两组龈下菌群数差异无统计学意义。结论螺丝固位与粘接固位两种固位方式对种植义齿周围软组织及边缘骨吸收的影响无显著差异。在修复后短期内，螺丝固位组厌氧菌总数、具核梭杆菌检出量较粘接固位组高，但在12个月时二者无明显差异。%Objective To compare the difference of health condition of peri-implant tissue and subgingival bacterial distribution between cement-retained and screw-retained implant dentures.Methods A total of 36 cases (68 implants) with maxillary and mandibular dentition defect received implant restoration. Thirty-three implants used screw-retained restoration and 37 implants used cement-retained restoration. The patients were followed up for 3, 6 and 12 months after restoration and the clinical indexes, such as implant probing depth (PD), modified plaque index (mPLI), modified sulcus bleeding index (mSBI) observed. The health conditions of peri-implant soft tissue were also compared. The peri-implant marginal bone loss (MBL) was measured. Comparison was made between the subgingival bacterial distributions of the two restoration methods through gathering subgingival bacterial specimens.Results There were no significant differences in PLI, mSBI, PD, and MBL between the two groups at all the three time points. The screw-retained group had higher amount of implant subgingival anaerobion than the cement-retained group three months after restoration (P<0.05). The amount of implant subgingival fusobacterium nucleatum was higher in the screw-retained group than in the cement-retained group six months after restoration(P<0.05). There was no significant difference in subgingival bacteria amount between the two groups 12 months after restoration.Conclusion The influence of cement-retained restoration and screw-retained restoration on peri-implant soft tissue and peri-implant marginal bone loss was not different. In the short period after restoration, the screw-retained group had higher amount of implant subgingival anaerobion and fusobacterium nucleatum than the cement-retained group, while their difference was not significant at 12th month.