| Objectives: In order to evaluate the treatment effect of the implant denture after alveolar ridge splitting with implanting simultaneously in the narrow alveolar ridge of the anterior maxillary region. To provide some clinical basis of this technology for long-term clinical application.Methods: Part one: 16 implants of 9 patients were collected according to a certain inclusion criteria, grouped by the preoperative alveolar ridge width and implant system .Group A: the preoperative alveolar ridge width less than 3mm (5 implants);Group B:the preoperative alveolar ridge width between 3mm and 4mm ( 5 implants);Group C: the preoperative alveolar ridge width large than 4mm (6 implants).The survey time is the day of surgery(TO),the day installing the implant superstructure(T1), six months to one year after the superstructure installing(T2) and two years to three years after the superstructure installing(T3).The survey time period is the day installing the implant superstructure to the day of surgery(T1-T0), the time of six months to one year after the superstructure installing to the time of the day installing the implant superstructure(T2-T1),the time of two years to three years after the superstructure installing to the time of six months to one year after the superstructure installing(T3-T2). The survey indicator is the changes of the height of alveolar bone in the mesial and distal around implants . SPSS 16.0 software for repeatable measurement of variance analysis, P values was set at 0.05. Part two: 11 implants of 9 patients were collected according to a certain inclusion criteria. 11 implants were single-tooth implant crowns using alveolar ridge splitting with implanting simultaneously. At average of 54.3 months (32-77 months) postoperative, the CBCT and intraoral photographs were taken. To choose different 5 points on the labial bone plate(the mesial point on the labial bone plate, the distal point on the labial bone plate,the middle point on the labial bone plate, the middle point between the mesial point and middle point on the labial bone plate, the middle point between the distal point and middle point on the labial bone plate) of every implant dental by CBCT. The bone height is the distance between this point to the apical point of implant was measured by CBCT. The vertical height is distance between the most crown of the alveolar ridge at the point to implant platform( The labial bone plate was higher than the implant platform as"+", the labial bone plate was lower than the implant platform as "-").To calculate the percentage of the vertical height on the labial bone plate and the length of implant. The PES score was evaluated on the soft tissue of implant dentures by intraoral photographs. SPSS 16.0 software was used for statistical analysis .The vertical height at every point and the percentage of the vertical height and the length of implant were normal distribution, and the PES score was non-normal distribution.The correlation analysis was performed using Spearman correlation coefficient. P values was set at 0.05.Results:Part one: By comparing the changes in the height of the mesial and distal alveolar ridge in group A, group B, group C, Ankylos group and Bego group,founding that the main effect of position and the interaction between position and time were not statistically significant, and the main effect of time of group B and group C was not statistically significant. However, The main effect of time of group A,Ankylos and Bego was statistically significant, there were significant differences in the changes of height of alveolar bone between the mesial and distal groups in different observation periods (P <0.05), and the changes of bone height of T2-T1 and T3-T2 was significantly higher than that of T1-T0 , and the difference was statistically significant (P <0.05). There was significant difference in the changes of height of alveolar ridge in Ankylos group (P <0.05), and the changes of the bone height of T2-T1 and T3-T2 was significantly higher than that of T1-TO,and the difference was statistically significant (P <0.05).The changes of the height of the alveolar ridge in the Bego group was significantly different (P <0.05), and the changes of the bone height of T2-T1 was significantly higher than that of T1-T0, and the difference was statistically significant (P <0.05).Part one: By comparing the changes of alveolar ridge height in the near and far positions of A, B and C groups in different survey periods.The main effect, group and time interaction of group A, B and C were found to be statistically significant. The main effect of time was statistically significant. From the time point of view, there was significant difference in the changes of the height of the alveolar ridge in the distal in different survey period in group A(P <0.05),and the changes of the bone height of T2-T1 and T3-T2 was significantly higher than that of T1-T0, and the difference was statistically significant (P <0.05).From the group point of view, in T1-T0 period, three groups of the changes of the alveolar bone height difference was statistically significant (P <0.05), B group, C group was significantly higher than the A group, the difference was statistically significant (P <0.05).Part one:By comparing the changes of the mesial and distal of alveolar ridge height in the Bego and Ankylos groups,in the different survey periods. There was no significant difference in the main effect, group and time interaction between the two groups, but the time effect was statistically significantPart two: The correlation coefficients of the PES and the mean vertical height(-2.57±3.00mm),the vertical height at mesial point on the labial bone plate (-1.25± 2.25mm),the vertical height at the distal point on the labial bone plate (-1.55 ±1.57mm),the vertical height at the middle point on the labial bone plate (-3.45±4.25mm) were 0.851, 0.823, 0.717, 0.846, the correlations were statistically significant(P <0.05). The correlation coefficient of the PES and the percentage of the vertical height and the length of implant (42.09% ±38.18%) was -0.005,The correlations was not statistically significant(P =0.989).Conclusions:1. When the preoperative alveolar ridge width less than 3mm, the loss of the height of the mesial and distal alveolar ridge around the implant in the survey time period is the day installing the implant superstructure to the day of surgery was greater than that of the time period after installing the implant superstructure, after alveolar ridge splitting with implanting simultaneously.2. When the preoperative alveolar ridge width less than 3mm, the loss of the height of the distal alveolar ridge around the implant was significantly higher than that of the preoperation alveolar ridge width large than 3mm,in the period of the day of surgery to the day installing the implant superstructures.3. There was no significant difference in changes of the height of alveolar ridge in the mesial and distal around implant with platform switching or platform matching in the abutment connection in the time period of postoperative time to the time of two years to three years after the superstructure installing, after alveolar ridge splitting with implanting simultaneously.4. The correlation coefficients of the PES and the mean vertical height, the vertical height at mesial point, the vertical height at the distal point, the vertical height at the middle point on the labial bone plate were positive correlation(p <0.05), in the postoperative average of 54 mouths , after alveolar ridge splitting with implanting simultaneously.5. There was no significant correlation between the PES and the percentage of the vertical height and the length of implant(P>0.05),in the postoperative average of 54 mouths, after alveolar ridge splitting with implanting simultaneously. |
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