后牙种植义齿一体化冠修复及软组织整复效果的评价  

Evaluation of the soft tissue manegement around the implant-suppotted crown using integrated abutment crown at the posterior region

作　　者：姚倩倩[1] 叶俊[1] 刘雯雯[1] 腾敏华[1] 成贤基[1] 莫安春[1] 

机构地区：[1]四川大学华西口腔医院口腔种植科,四川成都610041

出　　处：《中国口腔种植学杂志》2011年第1期21-22,共2页Chinese Journal of Oral Implantology

摘　　要：目的:局部种植义齿冠修复方式可分为粘接固位修复和螺栓固位修复两种。粘接固位较螺栓固位在受力,美观和被动就位上有较大的优越性,但对于冠破损需要修改时,螺栓固位有着粘接固位所不及的优势,同时也避免了粘结剂的遗留对牙龈健康的影响。常规的螺栓固位方式,是先将固位基台与种植体连接后,用螺丝将冠固定在基台上,由于固位力小易出现松动,但对于后牙颌间距离低且咬合紧或植体植入位置不佳时,效果并不理想。而且,后牙种植义齿冠修复容易出现牙龈乳头无法良好塑形充满楔状隙,从而影响美观并容易引起水平性食物嵌塞。基台冠一体化修复的方式是基台与冠为一整体通过牙合面开孔螺栓固位方式进行修复。本研究评价后牙种植体冠修复方式中选择行一体化冠修复并观察其对软组织同期整复的临床效果。材料与方法:使用两种方法进行一体化冠修复:一为基台与冠整体铸造后牙合面开孔螺栓固位修复;二为采取冠分体铸造后预留冠牙合面螺丝孔,将基台与冠粘结成一体,取下基台一体化冠于口外去除多余粘结剂后放置口内再通过螺栓固位。对软组织整复也分两种,一种为先用暂冠逐步整复软组织后行冠修复;二为在试戴一体化冠时同时将其作为对软组织进行整复的方式,并评价两种操作对软组织整复的效果。冠修复材料选用金属烤瓷或聚合瓷。29例患者植入种植体共48枚,其中14例患者应用ITI种植体系统植入19枚植体,15例患者使用OsstemGS种植体系统植入植体29枚。上部结构修复均使用基台一体化冠修复方式,ITI系统均为单冠修复,OsstemGS系统采用单冠或联冠修复。其中ITI系统2例患者2枚植体,OsstemGS系统3例患者3枚植体进行种植植入术后使用种植体临时义齿通过数次复诊,逐步整复软组织后依整复后的软组织外形取模,一体化冠修复。余病例均�Purpose：There are two ways in the prosthodontics of fixed partial implant treatment： screw-retained crown and cement-retained crown.When coming with stress distribution,aesthetic and passive fit of the crown,cement-retained crown establish superiority over screw-retained crown.While it happens to a damaged crown which need to repair or a wrong implant site,screw-retained crown is better than cement-retained crown to be the first choice and it avoid gingivitis which induced by remanet cement.Conventional screw-retained crown procedure is that fit abutment on implant first,and then tight abutment screw with the crown.It would loosening in function,resulting in gingiva recess and horizontal food impaction.Integrated abutment crown（IAC） is the whole body of abutment and crown which fixed on implant with screw on occlusal surface.The aim of the present study was to evaluate the soft tissue management around the implant-supported crown using IAC restoration at the posterior region.Materials and Methods： IAC was restored by two ways：one is the abutment was casted with the crown simultaneity and then screw-retained;the other is abutment and crown were casted respectively,cement them,remove remanet cement and finally retained by screw.And also there is two ways to manage soft tissue：one is using temporary crown to shape soft tissue progressively,and then take the customed impression to fabricate the final crown;the other is try- in the IAC and was retained by screw with managing the soft tissue contemporary.Porcelain or polymer ceramic was fused to the metal of crown.29 patients underwent implant surgery and 48 implants were inserted and restored.19 implants of 14 patients use the ITI system,while 29 implants of 15 patients use the OSSTEM GS system.When managing the soft tissue,only 2 restorations of ITI and 3 restorations of GS use the former program.Prosthodontic procedures contain the radiograthic confirmation of abutment placement uniformly.Follow-up time after operation was 6 months to 1 year to evaluat

关 键 词：种植体 一体化冠修复 软组织整复 

分 类 号：R783.6[医药卫生—口腔医学]