种植体—基台微间隙对种植体颈部周围骨的影响  

Effect of implant-abutment microgap on bone tissues surrounding the necks of implants

作　　者：苟敏[1] 蔡潇潇[1] 

机构地区：[1]口腔疾病研究国家重点实验室华西口腔医院种植科(四川大学),成都610041

出　　处：《国际口腔医学杂志》2015年第6期733-738,共6页International Journal of Stomatology

摘　　要：目前,种植修复多采用两段式种植体,由于行使生理功能时的咀嚼负荷、制造的误差和种植体—基台连接处的微动,种植体—基台微间隙不可避免。微间隙在颌骨内的深度越深,种植体颈部周围牙槽骨吸收越多;内连接系统比外连接系统有更小的种植体颈部周围骨吸收,带锥度的内连接系统的骨吸收比对接式连接系统小;种植体—基台的密合性越好,种植体颈部周围牙槽骨的吸收越少;应用平台转移技术,可以有效地减少种植体颈部周围牙槽骨的吸收。种植体—基台微间隙对种植体颈部周围骨的影响主要是通过微间隙处的微渗漏和微动来实现的,微渗漏又分为细菌微渗漏和小分子微渗漏,细菌和小分子可以通过微间隙进入种植体内部定居、繁殖,成为种植体周围炎的一个感染灶,微动可以产生局部应力,并且促进微渗漏的发生。总之,在临床治疗中,对于对接式连接系统,选择微间隙平齐或者高于牙槽嵴水平的种植深度,对于带锥度的内连接系统,选择微间隙低于牙槽嵴顶水平的种植深度,尽量选择内连接系统和密合性较好的种植系统,合理应用平台转移技术,以达到保存种植体颈部周围牙槽骨的目的。本文就种植体—基台微间隙对种植体颈部周围牙槽骨的影响及机制作一综述。Two-stage implant systems are currently adopted in most implant prostheses. However, an implant- abutment microgap inevitably forms because of masticatory load under physiological function, manufacturing errors, and micromotion. More alveolar bone is absorbed when a deep microgap forms in the jaw. Additionally, less bone is resorbed around the necks of implants in the internal connection systems than in the external, as well as in the conical intemal connection systems than in the butt joint connection systems. Less bone is also resorbed when the implants and the abutments are highly compatible. Platform switching technology can effectively reduce alveolar bone absorption around the necks of implants. Implant-abutment microgaps mainly affect the bones around the necks of implants via micromotion and microleakage, including bacterial and molecular leakages. Bacteria and small molecules enter the interior of the implants through the microgaps, settle and breed, and then become an infection focus of the peri-implantitis. Micromotion generates local stress and promotes microleakage. To preserve the alveolar bone around the necks of implants, we should select the equicrestal or supercrestal implant depth for the butt joint connection systems and the subcrestal implant depth for the conical internal connection systems, use the intemal connection systems and implant systems, which offer good compatibility, and then apply the platform switching technology reasonably. This study aims to summarize the effect of implant-abutment microgap on the bone surrounding the necks of implants, including its mechanism.

关 键 词：牙种植体 基台 微间隙 微渗漏 微动 牙槽骨 

分 类 号：R783.6[医药卫生—口腔医学]