目的:观察置骨法重塑种植牙牙间乳头的稳定性,探讨种植牙牙间乳头重塑的可行性方法.方法:选取102例牙周骨质较好、两颗及以上连续缺失的种植病例,分成两组,每组51例.置骨组在植入种植体时,其顶部高于骨皮质0.5～1.0mm.在种植体之间的骨皮质处打微细滋养孔,取邻近牙槽骨或回收自体骨与Bio-oss骨粉混合,置于种植体间和唇侧牙龈不饱满处,将Bio-Gide膜剪孔,严密覆盖种植体周围,固定.将龈瓣以L型转瓣分别缝于种植体间,或者在种植同期用"split-finger"技术恢复重建龈乳头.共修复种植体间乳头76个.另一组则在完成常规种植体植入后,将牙龈转瓣缝合,在唇侧不饱满处,取上腭黏膜垫入.共修复种植体问乳头67个.在12个月时分别测定两组牙龈乳头指数(papilla index score,PIS)和主观美观指数以及种植体周围袋的深度,进行比较.结果:置骨组种植体间乳头的PIS 3级(P＜0.01)和主观美观指数Ⅰ级数量(P＜0.05)明显高于常规组.置骨组比常规组更能达到最佳的龈乳头修复.结论:置骨法重塑种植体牙间乳头,在多颗种植牙时有一定的应用价值.%Objective: To observe the stability of gingival papilla between the implants remolded by replanting bone and discuss the feasibility of remolding the gingival papilla Methods: 102 cases were chose which had better bones around the teeth and had two or more loosing teeth. They were divided into two groups and each group had 51 cases. In the replanting group, the top of implants were higher 0.5-1.0 mm than the bone level when the implants were embedded into the jaw.Punching in the bone between the implants, mixing bones fetched from vicinity or reclaimed and Bio-oss, we replanted admixtures between the implants and where were not filled at the lip sides. The Bio-Gide membranes were cut and fastened to match the area L-type petals were stitched between the implants. "split-finger" technique were also used. 76 gingival papillae were done. In another group, the mucosa fetched from the up jaws was placed down to the up lip side and between the implants after the implants were embedded in a general way. 67 gingival papillae were done. We had determined and compared papilla index score (PIS) and subjective aesthetic score and depth of the pouches after 6 months and 12 moths.Results: In the replanting group, the number of papilla index score 3 (P＜0.01) and subjective aesthetic score Ⅰ (P＜0.05)was more than that in another group. Replanting bone can better rehabilitate the gingival papillae between the implants comparatively. Conclusion: The way of remolding gingival papilla by replanting bone counts for application when more teeth need to be implanted.
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