重度歯周炎におけるAll-on-4即時荷重インプラント義歯の臨床効果と審美性の観察

Clinical Effect and Aesthetic Observation of All-on-4 Immediate Loading Implant Denture in Severe Periodontitis.

抄録

目的:

重度歯周炎におけるAll-on-4即時荷重インプラント義歯の臨床効果と審美性を検討する。

Objective: To explore the clinical effect and aesthetics of All-on-4 immediate loading implant denture in severe periodontitis.

方法:

2017年2月から2019年2月までに当院に入院した重度歯周炎による歯列喪失の患者60名を合計で抽出した。この患者を修復方法の違いにより、観察群（＝30名）と対照群（＝30名）にランダムに分けた。コントロール群には従来のインプラント修復治療を、観察群にはAll-on-4即時荷重インプラント義歯修復を行った。両群の臨床効果，歯周指標，審美効果，合併症を比較し，血清レプチン（LEP），腫瘍壊死因子（TNF-），C反応性蛋白（CRP），インターロイキン-6（IL-6）の濃度を測定した．

Methods: Totally, 60 patients with dentition loss caused by severe periodontitis who were admitted to our hospital from February 2017 to February 2019 were selected. The patients were randomly divided into the observation group ( = 30) and the control group ( = 30) according to different restoration methods. The control group was used in traditional implant restoration treatment, and the observation group was used in All-on-4 immediate loading implant denture restoration. The clinical effect, periodontal index, aesthetic effect, and complications of the two groups were compared, and the levels of serum leptin (LEP), tumor necrosis factor- (TNF-), C-reactive protein (CRP), and interleukin-6 (IL-6) were measured.

結果:

観察群の総有効率（83.33％）は対照群（60.00％）よりも高かった（< 0.05）。治療後、両群のプラーク指数、歯肉溝出血指数、探針の深さは治療前に比べて低く（< 0.05）、両群間に有意差はなかった（> 0.05）。治療後、両群の血清LEP、TNF-、CRP、IL-6は治療前に比べて低く、観察群の血清LEP、TNF-、CRP、IL-6は対照群に比べて低かった( < 0.05)。観察群の歯の審美率（90.00％）は対照群（66.67％）よりも高かった（< 0.05）。合併症の発生率は、両群間で有意な差はありませんでした（＞0.05）。

Results: The total effective rate of the observation group (83.33%) was higher than that of the control group (60.00%) ( < 0.05). After treatment, the plaque index, gingival sulcus bleeding index, and depth of exploration of the two groups were lower than those before treatment ( < 0.05), and there was no significant difference between the two groups ( > 0.05). After treatment, the serum LEP, TNF-, CRP, and IL-6 in both groups were lower than before treatment, and the serum LEP, TNF-, CRP, and IL-6 in the observation group were lower than that in the control group ( < 0.05). The aesthetic rate of teeth in the observation group (90.00%) was higher than that in the control group (66.67%) ( < 0.05). There was no significant difference in the total incidence of complications between the two groups ( > 0.05).

結論:

All-on-4即時荷重インプラント義歯は、重度歯周炎の治療に効果があり、歯周病の健康維持、炎症レベルの低下、審美性の向上に寄与し、安全性も高いと考えられる。

Conclusion: All-on-4 immediate loading implant denture has a good effect in the treatment of severe periodontitis, which is conducive to maintaining periodontal health, reducing the level of inflammation, improving aesthetics, and has high safety.