后牙种植CAD/CAM螺丝固位上部结构修复临床效果的初步观察  

Observing the effect of customed crown in the molar area's in implant restoration

作　　者：周冯娟[1] 滕敏华[1] 李冠达[1] 赵睿婷[1] 成贤基[1] 莫安春[2] 

机构地区：[1]四川大学华西口腔医学院口腔疾病研究国家重点实验室,四川成都610041 [2]华西口腔医院

出　　处：《中国口腔种植学杂志》2013年第3期138-142,148,共6页Chinese Journal of Oral Implantology

摘　　要：目的:探讨后牙种植CAD/CAM螺丝固位上部结构修复方法在后牙种植病例中的应用以及对其临床应用效果进行评价。方法:选取到四川大学华西口腔医院种植中心就诊的后牙种植术后病例11例,植入种植体18颗。植入缺牙区的种植体为ITI种植系统、Noble种植系统,植入植体后3-6个月取模、灌制超硬石膏模型,选用Tibase基台或Tibase-全瓷基台、CAD/CAM制作威兰德氧化锆全瓷冠,均采用牙冠面开孔螺丝固位修复方式,1-2年后复查,并对修复效果进行评价。结果:经1-2年随访观察,全冠的形状与邻牙相协调,全冠修复体未见明显磨耗,面螺丝孔开口处未见崩瓷现象,牙冠边缘与基台密合度良好,近远中邻接面接触关系正常,种植周围组织正常,未见有牙冠与中央螺丝松动,其中有1颗牙冠与基台分离、1颗牙龈萎缩暴露金属,修复两年成功率为16/18,效果满意。结论:个性化牙冠在后牙种植修复中的临床应用效果良好,是后牙种植义齿修复选择的一种好方法。Objective： Exploring the application of CAD/CAM ceramic crown or abutment with a hole by screw-retention in implant supported fixed denture and evaluating its clinic effect simply. Methods：Randomly selected 11 patients came to The West China Stomatology Hospital, and the 11 patients underwent implant surgery and 18 implants were inserted and restored. ITI implant system, Noble implant system were choosed. Impressions were taken after implant surgery 3-6 months, Tibase or Tibase-abutments and all-ceramic crowns by CAD/CAM were selected. Follow-up time after operation was 1 to 2 year to evaluate losseness of crowns and health of soft tissues. Result： After 1 to 2 years follow-up, all the patients with this prosthetic plans came to the same destination, all of them with all-ceramic crown have no screw looseness on function and use the crowns directly could manage ideal gingiva margin and papulla height which avoid gingivitis induced by remanet cement and horizontal food impaction, porcelain breakages haven＇t been observed. Only one crown lossen because of the cement fracture, and one abutment exposed with gingival recession, the two years restoration success rate is 16/18 and the clinic effects were satisfactory. Conclusion： Application of customed crown and abutment can get a satisfactory clinic effect in implant supported fixed denture, this is a good choice to restore the loosed teeth in molar both up and lower jaw.

关 键 词：CAD CAM 螺丝固位 Tibase-全瓷基台 口腔种植 

分 类 号：R783[医药卫生—口腔医学]