单颌种植即刻修复体戴用6个月以上的并发症及影响因素分析  

Complications of implant-supported full-arch immediate prosthesis： a retrospective analysis of 114 cases

作　　者：沈惠丹 邸萍[1] 李健慧[1] 罗佳[1] 张宇[1] 林野[1] Shen Huidan, Di Ping, Li Jianhui, Luo Jia, Zhang Yu, Lin Ye(Department of Implantology, Peking University School and Hospital of Stomatology ＆ National Clinical Research Center for Oral Diseases ＆ National Engineering Laboratory for Digital and Material Technology of Stomatology ＆ Beijing Key Laboratory of Digital Stomatology, Beijing 100081, Chin)

机构地区：[1]北京大学口腔医学院·口腔医院种植科口腔疾病国家临床研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室,100081

出　　处：《中华口腔医学杂志》2018年第4期236-242,共7页Chinese Journal of Stomatology

基　　金：国家重点研发计划（2016YFC1102705）;首都卫生发展科研专项（首发2018-2-4102）

摘　　要：目的通过追踪观察单颌种植即刻修复体患者临床并发症并探讨其长期戴用的可行性，分析并发症的影响因素。 方法选取2008年4月至2016年6月于北京大学口腔医学院·口腔医院种植科行单颌种植即刻修复且修复体戴用6个月以上的患者，采用回顾性队列研究的方法，记录患者基本信息和治疗情况，采用Cox比例风险模型进行修复体折裂影响因素的分析。 结果共纳入114例患者，年龄为（56.7±10.2）岁，纳入144个修复体，即刻修复体戴用中位时间为17.6个月，54%（62/114）的患者发生并发症，其中30例患者经历了1次以上的修复体并发症。并发症主要为前牙区人工牙折裂和后牙区基托折裂。即刻修复体戴用第1年折裂发生概率大于后续年份。多因素回归结果显示，修复体纤维加强（相对风险度=0.486，P=0.017）与固定对颌牙列（相对风险度=2.272，P=0.016）与修复体折裂显著相关。 结论单颌种植即刻修复体长期戴用并发症发生率高，最常见并发症为修复体折裂，第一年内发生概率最高。对颌为活动修复体时可考虑长期戴用碳纤维加强的树脂即刻修复体。ObjectiveTo evaluate the feasibility of long-term function of implant-supported full-arch immediate prosthesis via assessing the complications and risk factors. MethodsThis historical cohort study included patients treated with implant-supported full-arch restoration under immediate loading protocol between April, 2008 to June, 2016 and wearing the immediate prosthesis for more than 6 months. Medical charts were reviewed for patients＇ general information, implant information, prosthetic information and details of prosthetic complications. COX proportional hazards ratio model was adopted to analyze the potential risk factors for prosthesis fracture.ResultsA total of 114 patients with a mean age of （56.7±10.2） years old and 144 prostheses were included. The median wearing time of immediate prosthesis was 17.6 months. Sixty-two （54%） patients experienced prosthetic complication, 30 of them suffered more than once. Artificial teeth fractures were more common in anterior region while resin base fractured more often in the posterior region. The possibility of immediate prosthesis fracture in the first year was high but declined over the following years. COX regression analysis showed that fibre-reinforcement （HR=0.486, P=0.017） and rigid opposing dentition （HR=2.272, P=0.016） were significantly related to the prosthesis fracture.ConclusionsLong-term function of implant-supported full-arch immediate prosthesis renders a high prosthetic complication prevalence, featuring the prosthesis fracture as the most common complication and the first year of highest fracture probability. Fibre-reinforced acrylic immediate prosthesis may function well in cases with a removable denture restored opposing jaw.

关 键 词：牙修复体 手术后并发症 COX比例风险模型 

分 类 号：R783.6[医药卫生—口腔医学]