Clinical Effect Of Single Upper Anterior Teeth Implantation Combined With Guided Bone Regeneration In The Reconstruction Of Proximal And Distal Alveolar Crest

Objective To investigate the proximal and distal alveolar crest height of single anterior teeth with missing teeth,and to evaluate the changes of the distance between the crest of the implant proximal and distal alveolar crest and the contact point of the adjacent teeth immediately and 6 months after operation by CBCT in the cases of implant near and far alveolar crest reconstruction using Guided Bone Regeneration(GBR).The effect of head closure and aesthetics of soft tissue were evaluated,and the effect of GBR on the reconstruction of the crest of the proximal and distal alveolar ridge of single anterior dental implant in the same period was evaluated,which provided a reference for clinicians to reconstruct the crest of the proximal and distal alveolar ridge of single implant.Methods According to certain inclusion criteria,a total of 28 patients with single missing upper anterior teeth were selected and 34 single missing teeth were included in the study.The missing teeth were divided into routine implant group according to the distance between the proximal and distal alveolar ridge crest and the contact point of adjacent teeth,and GBR group according to the distance between the proximal and distal alveolar ridge crest and the contact point of adjacent teeth.CBCT software was used to measure the distance from the crest of the distal and near alveolar ridge to the contact point of the adjacent teeth immediately and 6 months after implantation.The changes of bone mass at different sites were calculated immediately and 6 months after operation.The width of keratinized gingiva was measured by periodontal probe and ruler at the highest point of the implant’s proximaland distal gingival papilla and lip neck margin.Intraoral photographs were taken to evaluate the proximal and distal gingival papilla index and the PES red aesthetic score(Pink Esthetic Score-PES).SPSS23.0 software was used for t test and correlation analysis,and P<0.05 was considered statistically significant.Result There was no statistical difference between the two groups in gender and age,and the implant survival rate was 100%.2.The gingival biotype,gingival papilla index,keratinized gingival width and PES aesthetic score of the two groups were all higher than 0.056 months after operation.3.Pearson correlation analysis between gingival biotype,keratinized gingival width and gingival papilla index in both groups showed that P value was less than 0.05.4.The distance from the crest of the proximal and distal alveolar ridge to the contact point of the adjacent teeth in the two groups was greater than 0.05 immediately after operation and 6 months after operation.5.Six months after implantation of single maxillary anterior teeth: the correlation coefficient between the distance from the crest apex of the mesial alveolar ridge to the contact point and the papillary index of the mesial gingiva was r=-0.535,P=0.001<0.05,and the correlation coefficient between the distance from the crest apex of the distal alveolar ridge to the contact point and the papillary index of the distal gingiva was r=-0.377,P=0.028<0.05.There was no correlation between the thickness of the plate of the labial side of the implant and the papillary index of the Relevance,P > 0.05.Conclusion 1.During the observation period,the same gingival papilla closure and aesthetic effect as the conventional implant group could be achieved by using GBR technique to reconstruct the crest and labial bone plate of the proximal and distal alveolar.2.The sealing effect of gingival papilla of single implant is related to the width of keratinized gingiva and gingival biotype.3.GBR technique can restore the crest height of the distal and near alveolar ridge to the same level as that of the conventional implant group.4.The height of the gingival papilla of the anterior teeth implanted on a single implant is related to the distance from the crest of the proximal and distal alveolar ridge to the contact point of the adjacent teeth,but notto the thickness of the labial median bone plate.