| Objective : To observe bone remodeling after the locking-tapered implants were placed in the molar area,and to analyze the factors affecting the buccal-lingual alveolar bone remodeling.Methods: From October 2018 to October 2019,the patients who underwent implant surgery in the Department of Stomatology of the Fourth Affiliated Hospital of Nanchang University were selected as the volunteers who met the inclusion criteria.The surgery were performed by the same operator.The inflammatory tissue was thoroughly removed after minimally invasive tooth extraction and the socket was rinsed with a large amount of saline.At the same time,the locking-taperd implant was placed,autologous bone collected during the preparation of cavity for the neck of the implant,PRF being covered and loose suture of wound.Four months later,all patients underwent second-stage surgery.CBCT was taken on the day after implant placement(T0)and one year after restoration(T1).The images were processed by CS 3D Imaging software,and the coronal images of the implants were obtained,the remodeling of the buccal-lingual bone around the implant was evaluated by the following parameters:(1)the thickness of the buccal-lingual bone wall(OC-IC)at the neck of the implant,the distance between the midpoint of the neck of the implant and the connection of the buccal-lingual line(R-H);The horizontal distance(IC-S)between the bone defects in the neck of the implant;(2)1 mm(L11),1 mm(L0),1mm(L1),3 mm(L3),5 mm(L5),OC-OC,OC-S,R-C(B/L),vertical distance between alveolar crest and implant neck.SPSS24.0 statistical software was used to analyze the bone changes of height and width on the coronal plane of T0 to T1.Results: A total of 31 implants from 24 patients were included in the study,and the survival rate was 100%.With T0 as the baseline,the height of buccal and lingual alveolar crest and alveolar bone contour of T1 implants changed significantly(P <0.05).The average height of buccal bone decreased by 1.60 mm,and the average height of lingual bone decreased by 0.89 mm.The closer to the root of the implant,the smaller the buccal-lingual bone width(OC-OC)and the distance between the lateral buccal bone wall and the implant(IC-S(B))were(P < 0.05).When the implant depth(R-H)≥ 2 mm,the buccal-lingual bone width(OC-OC)absorption at L11 level was smaller(P < 0.05).When R-H < 2 mm and R-H ≥ 2 mm,the absorption of alveolar crest height(R-C(B / L))and buccal-lingual bone width(OC-OC,L0,L1,L3,L5 levels)did not increase(P > 0.05).At T0 stage,there was no significant difference in the vertical bone height and horizontal bone width between the buccal and lingual sides of the implant and the buccal hopping gap(IC-S)greater than 2 mm and the buccal bone wall thickness(OC-IC)greater than2 mm(P > 0.05).At T0 stage,the implant depth(R-H)≥ 2 mm,the implant under the buccal bone edge(R-C(B))≥ 2 mm,and the buccal bone wall thickness(OC-IC)≥ 2 mm were beneficial to the buccal bone wall thickness ≥ 2 mm of the implant neck after 1 year of repair(P < 0.05).Conclusion: 1.The buccal and lingual bone contour of the implant will collapse in varying degrees after one year of repair when the molar area is immediately implant placement with locking-tapered implants and the bone defect gap is not filled with bone graft materials,but it does not affect the survival and normal function of the implant.2.It is recommended that the locking-tapered implants be inserted at least2 mm below the crest line of buccal and lingual alveolar ridge when it is used for immediate implant in molar area. |
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