后牙连续缺失后短种植体联冠修复早期负重的临床研究  

A prospective study on the application of 6-mm-long implants in the upper and lower posterior edentulous regions

作　　者：邹立东[1] 韩劼[2] 吴敏节[1] 张晓[3] 唐志辉[1] 孟焕新[1] Zou Lidong;Han Jie;Wu Minjie;Zhang Xiao;Tang Zhihui;Meng Huanxin(Second Clinical Division,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 100101,China;Department of Periodontology,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;First Clinical Division,Peking University School and Hospital of Stomatology ＆ National Clinical Research Center for Oral Diseases ＆ National Engineering Laboratory for Digital and Material ~Technology of Stomatology ＆ Belting Key Laboratory of Digital Stomatology,Bering 100034,China)

机构地区：[1]北京大学口腔医学院·口腔医院第二门诊部国家口腔疾病临床医学研究中心 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,100101 [2]北京大学口腔医学院·口腔医院牙周科,100101 [3]北京大学口腔医学院·口腔医院门诊部,100101

出　　处：《中华口腔医学杂志》2018年第10期653-658,共6页Chinese Journal of Stomatology

摘　　要：目的 观察评估使用6 mm短种植体早期联冠修复后牙连续缺失的临床效果和种植体周围边缘骨水平的变化.方法 纳入2011年2月至2012年2月于北京大学口腔医学院·口腔医院牙周科、第一门诊部、第二门诊部因牙列缺损就诊的45例患者,每例患者植入2～3枚种植体,共植入95枚6 mm种植体,术后6周早期负重,采用螺丝固位方式联冠修复.术前、术后、修复体戴人及修复后6、12、24个月行口腔检查及影像学检查.结果 术后5周有5例患者的5枚种植体缺乏稳定性,其中4枚种植体被取出,4例患者未按研究设计早期负重,其余共36例患者76枚种植体按照研究设计顺利完成整个治疗和2年随访,负重后无种植体脱落,种植体存留率100％ （76/76）.所有病例术后肿痛反应轻微,负重后6、12和24个月时种植体周围的边缘骨吸收不明显,分别为（0.04±0.29） mm、（-0.11 ±0.44）mm和（0.00±0.53） mm.负重2年后,17％（12/69）的种植体周围牙槽骨高度增加,57％（39/69）的种植体牙槽骨水平无明显变化,只有26％ （18/69）的种植体发生牙槽骨吸收,高度降低,但其中只有3％（2/69）的种植体骨吸收超过1.00 mm.随访2年期间种植体的探诊深度增加约0.50 mm,但差异并无统计学意义（P＞0.05）.结论 6 mm短种植体联冠修复用于后牙连续缺失时效果较稳定,对后牙区骨高度不足的患者是一个较好的治疗选择.Objective To assess clinical and radiographic outcomes of short implants （length six mm） in the posterior region and early-loading with splinted fixed dental prostheses.Methods Forty-five patients were recruited at 3 centers and 2-3 implants （diameter 4 mm,length 6 mm） were implanted in each case.Totally,ninty-five implants were placed,using one-stage surgery protocol and loaded with a screw-retained splinted fixed prosthesis 6 weeks later.Clinical and radiographic examinations were performed preoperatively,post-surgery,at loading,and 6,12 and 24 months after prosthesis placement.Results Four implants were removed before loading.A total of 36 patients with 76 implants completed the whole treatment and 2 year follow-up according to the research design.No implant was lost after loading,and the 2-year survival rate of the implant was 100%（76/76）.In all cases,the response of swelling and pain after operation was mild,and the bone resorption around the implants was not obvious at 6 months [（0.04± 0.29） mm],1 year [（-0.11±0.44） mm],and 2 years [（0.00±0.53） mm] after loading.Bone loss less than 1.00 mm was found only in 26% （18/69） implants after 2 years of loading,and the height of the alveolar bone around 17% （12/69） of the implant increased.During 2-year follow-up,the probing depth of the implants increased by nearly 0.50 mm,but there was no clinical significance （P〉0.05）.Conclusions The 2-year results of this study showed that the 6-mm-long implants can be a predictable procedure,especially in situations with limited bone height in posterior edentulous regions.

关 键 词：牙种植体 牙周炎 牙修复体 

分 类 号：R783[医药卫生—口腔医学]