| Objective: With the progress of technical means and the gradual improvement of patients’ needs,in recent years,immediate implant has gradually started to apply in molar.This paper will analyze whether the clinical effects of immediate implant and delayed implant in molar area are different by observing and studying the cases of immediate implant and delayed implant of posterior teeth,so as to provide clinical basis for the selection and formulation of surgical plans.Methods: Thirty patients(18 males and 12 females,mean age 54.47)treated with implant placement in molar area were selected in the Affiliated Stomatological Hospital of Dalian Medical University from 2016 to 2018.A total of 35 implants were implanted.According to the time of implantation,the patients were divided into two groups: immediate implant group(15 cases,17 implants),delayed implant group(15 cases,18 implants).The average observation period was 16.74 months.Patients with gingivitis and periodontitis were treated with total supra-gingival scaling or systemic periodontal therapy before surgery.Flaps or flapless was selected as needed.In patients with bone defect,bone augmentation was performed.The bone grafting techniques used in the operation include: bone grafting in alveolar fossa and GBR.Bone grafting and membrane materials included: autogenous bone,PRF,artificial bone,collagen membrane.Upper repair was performed 3-6 months after implantation,followed by observation period.Preoperative,intraoperative,postoperative and follow-up medical records,imaging examinations and intraoral photos were collected,and satisfaction survey was conducted in the corresponding period.The evaluation indicators were implant torque,postoperative reaction,implant survival rate,the width of keratinized mucosa,bone loss,patient satisfaction and complications.The differences of these indexes were compared and assessed statistically for the influence for molar area.Results: 1.All these cases displayed normal healing after surgery without nerve and adjacent tooth damage,no perforation of the maxillary sinus mucosa,no other complications were found.2.The mean insertion torque in the immediate group was 41.76N?cm and 39.72N?cm in the delayed group.No statistically significant difference was found(P=0.60).3.The survival rate was 100% in immediate group and delayed group.4.The mean keratinized mucosa width was 5.02 mm in the immediate group and 4.68 mm in the delayed group when repaired,and in the time of followed-up the mean keratinized mucosa width was 4.93 mm in the immediate group and 4.56 mm in the delayed group.5.Immediate group and delayed group bone absorption in mesial was 0.86 mm and 0.77 mm,and the bone absorption in distal was 0.85 mm and 0.79 mm.The initial thickness of gingiva ? 2 mm and(29)2mm bone absorption in mesial was 0.91 mm and 0.83 mm in distal when used platform switching implants.6.No surgical complications occurred in all patients.Two immediate implants and Four delayed implants had food impaction,and each group had 1 gingivitis patient.All complications improved after appropriate treatment.Conclusions: In the molar area,tooth placement with immediate or delayed implant,acceptable clinical effects can be achieved by careful preoperative systemic and local condition assessment,reasonable operation method,appropriate implant and materials,choosing appropriate repair time and charging under the condition of periodic follow-up.The change of the bone and soft tissue levels have no significant difference.However,compared with delayed implant,immediate implant has advantages in reducing the number of operations and shortening the period of edentulous,but the patients’ physical tolerance is required to be higher and the operation is more complex,which requires the physician to have more clinical experiences. |
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