数字化方法测量种植体周围骨嵴上软组织高度可行性分析

doi:10.7518/hxkq.2023.2023089

摘要/Abstract

摘要：

目的探讨数字化方法测量种植体周围骨嵴上软组织高度的可行性。方法选择2022年8—12月于中国科学技术大学附属第一医院（安徽省立医院）口腔医学中心就诊的牙种植患者36例，共计43个种植牙位。所有患者完成口腔种植手术当天立即获取术后锥形束CT（CBCT）影像学资料与术前获取的口内数字化印模，导入口腔种植手术规划软件中进行图像的拟合，然后在种植区放置相同规格的虚拟种植体，调整种植体位置，与CBCT图像里的种植体影重叠，在种植体视图界面测量骨嵴上软组织高度（STH）（记为数字化方法测量组）。术中按照标准窝洞制备方法逐级制备种植窝洞并植入植体，使种植体上缘与牙槽嵴顶平齐，采用牙周探针测量STH（记为牙周探针测量组）。采用配对t检验比较数字化方法测量组与牙周探针测量组的STH差异，Bland-Altman检验分析两种方法的一致性，组内相关系数（ICC）检验不同测量者使用数字化方法测量结果的可信度。结果两种方法测量种植区STH的差异无统计学意义（P>0.05），Bland-Altman检验分析两种方法的一致性较好，但下颌后牙测量结果显示牙周探针测量结果大于数字化方法测量组，不同测量者采用数字化方法测量STH结果的ICC及其95%CI为0.992（0.986~0.996）。结论数字化方法测量种植体周围骨嵴上软组织高度的结果与牙周探针测量法较为一致，可靠性较好。

关键词: 数字化, 骨嵴上软组织高度, 锥形束CT

Abstract:

Objective This study aimed to investigate the feasibility of measuring the soft tissue height of bone cristae around implant by digital method. Methods A total of 36 patients with dental implants were selected from the Dental Medicine Center of the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from August 2022 to December 2022. A total of 43 dental implants were enrolled. All postoperative cone beam CT (CBCT) imaging data and intraoral digital impressions obtained before surgery were immediately obtained by the patients on the day of completion of oral implant surgery and they were imported into oral implant surgery planning software for image fitting. Then, virtual implants of the same specification were placed in the planting area, and the implant position was adjusted to overlap with the implant shadow in the CBCT image. Supracrestal tissue height (STH) was measured at the implant view interface (digital group). During the operation, implant holes were prepared step by step in accordance with the standard preparation method, and implants were implanted. The upper edge of the implant was flushed with the crest of the alveolar ridge. STH was measured by perio-dontal probing (periodontal probe group). Paired t-test was used to compare the STH differences between the digital and periodontal probe groups. Bland-Altman test was used to analyze the consistency of the two methods. Intra-group correlation coefficient (ICC) was used to verify the reliability of the results measured by different surveyors using di-gital methods. Results No statistical significance was observed in the STH difference between the two methods (P>0.05). Bland-Altman test showed good consistency between the two methods, but the measurement of mandibular posterior teeth showed that the results of periodontal probe were greater than those of digital method. The ICC and 95%CI of the STH results measured digitally by different surveyors are 0.992 (0.986-0.996). Conclusion The digital me-thod is in good agreement with the periodontal probe method in measuring the soft tissue height of the bone cristae around the implant.

Key words: digitization, supracrestal tissue height, cone beam CT

中图分类号:

R 783.6

李璐欣, 刘红红, 陈佳, 张志宏, 桑潇, 张莉丽, 王元天. 数字化方法测量种植体周围骨嵴上软组织高度可行性分析[J]. 华西口腔医学杂志, 2023, 41(4): 426-433.

Li Luxin, Liu Honghong, Chen Jia, Zhang Zhihong, Sang Xiao, Zhang Lili, Wang Yuantian.. Feasibility analysis of digital method for measuring supracrestal tissue height crest around implant[J]. West China Journal of Stomatology, 2023, 41(4): 426-433.

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参考文献 25

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组别	颊侧	舌侧	近中	远中
数字化方法测量组	2.26±1.02	2.54±0.89	3.00±0.94	2.79±0.91
牙周探诊测量组	2.24±1.17	2.59±1.34	2.91±1.15	2.72±1.22
t值	-0.127	0.425	-1.060	-0.801
P值	0.899	0.673	0.295	0.427

组别	上牙	下牙	前牙	后牙
数字化方法测量组	3.19±1.19	2.41±0.80	3.71±1.42	2.56±0.90
牙周探诊测量组	3.15±1.33	2.36±0.87	4.00±1.73	2.47±0.93
t值	-0.346	-0.850	1.626	-1.460
P值	0.735	0.402	0.203	0.153

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