一段式细颈种植体用于小间隙缺牙修复的临床观察  

Clinical Observation for prosthesis of small edentulous space by one-stage narrow-neck implant

作　　者：黄忠楼[1] 韩龙[1] 孙桂芳[1] 

机构地区：[1]河北省沧州中西医结合医院口腔科

出　　处：《中国口腔种植学杂志》2009年第2期105-106,共2页Chinese Journal of Oral Implantology

摘　　要：目的:探讨一段式细颈种植体用于缺牙间隙偏小的单牙种植修复技术的适应症、操作技巧,评价其临床疗效。方法:使用HBIC一段式种植体植入25例牙缺失患者,共植入32枚种植体。采用非翻瓣(Flapless)一期法种植,不做临时冠修复,待愈合三个月后直接行粘结永久烤瓷冠修复。经检测种植体动度、GI及有无种植体周围炎、X线根尖片等指标,评价临床成功率。结果:随访2-4年,仅1例患者的2枚种植体松动、脱落,其余种植体均获成功,临床成功率为93%。讨论:①以往的研究表明,种植体与邻牙间在颈缘平面的最小距离至少有1mm,才可保护龈乳头和防止骨吸收的发生,细颈穿龈种植体,最大限度地保护了种值体与邻牙间牙龈桥宽度,可有效减少牙龈退缩和骨吸收的发生。②采用一期法、非翻瓣式手术可减少术后软组织渗血和牙龈乳头损伤,减轻了牙龈组织的炎性反应,有利于软组织愈合,减少种植体周围炎发生几率,本组患者在愈合期无一例种植体周围炎发生。③本组患者均采用延期(三个月后)冠修复负重方式,有利于形成健康的软组织封闭和良好的骨整合,冠修复时尽量降低牙尖高度,减少剪切力和侧向力,提高了种植成功率。结论:一段式细颈种植体用于小间隙单牙缺失种植修复要达到精良、美观的修复效果,其成功的关键取决于对适应症的把握,以及良好的手术和修复技术。Objective:A single dental implant prosthesis of small edentulous space by one-stage narrow-neck implant is a secure simple prosthesis.The report discussed the indication operating technique and the clinical effects of the prosthesis.Methods:25 patients(16 femals and 9 males)age range from 20 to 55 years old(mean age:38 years),were planted HBIC one-stage implant,including 32 implants.Implant teeth:9 maxillary canines,12 maxillary lateral incisors,8 submaxilla canines,3 submaxilla anterior teeth.All implants were planted to adopt one-stage and flapess technique by HBIC instrument and demand,torque from 30 to 45 Ncm,after planting,adjust direction and contour of implant,make it conform the demand of preliminary coronal restoration,and no do provisional coronal restoration.Tell patients not to morsus food with the teeth of implantation region and maintain oral hygiene,to attend the clinic on time,three months after healing,implants were restored by permanent porcelain complete veneer crown.Primary stability,GI,peri-implantities.apex radicis dentis X-rays films were analysed to determine the clinical results.Result:After 1-4 year follow-up,2 implants in 1case were lost.The clinical successful rate was 93%.Disscusion:1.The Subgingival location of the implant have great influence on the prosthetic results.If the implant to occupy the location of gingival papilla or buccolingual side bias,Not only the aesthetic result is of poor,but also it is very difficult in maintaining oral hygiene.Previous studies have shown that In order to protect the gingival papilla and prevent bone resorption,a minimum distance of the implant to adjacent teeth at the cervical margin plane should be 1mm.narrow-neck implant can maximize the protection of the gums bridge width between the implant and adjacent teeth,and can be effective in reducing gingival recession and bone resorption occurred.2.One-stage and flapless technique can reduce postoperative bleeding of the soft tissue and injury of the gingival papilla,and can reduce the acute respons

关 键 词：种植体 牙缺失 种植体周围炎 小间隙 一段式 细颈 

分 类 号：R783.3[医药卫生—口腔医学]