数字化导板辅助下中老年患者全口种植固定修复的长期临床效果观察  

Long-term clinical effect of full-mouth implant fixation in middle-aged and elderly patients with static computer-assisted implant surgery

作　　者：陈子强 周文娟 任静宜 柳忠豪 Chen Ziqiang;Zhou Wenjuan;Ren Jingyi;Liu Zhonghao(Department of Oral Implantology,Yantai Stomatological Hospital Affiliated to Binzhou Medical College,Yantai 264001,China)

机构地区：[1]滨州医学院附属烟台市口腔医院种植科,264001

出　　处：《中华口腔医学杂志》2020年第11期864-870,共7页Chinese Journal of Stomatology

基　　金：山东省医药卫生科技发展计划项目(2018WS036)。

摘　　要：目的评估中老年患者在数字化导板辅助下行种植全口固定义齿修复的长期临床效果。方法收集2012年11月至2016年1月在滨州医学院附属烟台市口腔医院种植科行数字化导板辅助下种植全口固定义齿修复的15例患者,年龄(58.6±5.3)岁(50~67岁),男性11例,女性4例。其中上颌牙列缺失15例,下颌牙列缺失8例,共植入145枚种植体。对比术后与术前设计的种植体三维位置,评估数字化导板精度。对患者进行为期5年的随访,评估种植体的存留率,并分别通过影像学检查及临床检查对种植体周围边缘骨吸收及并发症进行评估。结果对数字化导板精确度评估结果显示,种植体肩部偏差为(0.78±0.59) mm,根部偏差为(1.38±0.63) mm,深度偏差为(0.65±0.35) mm,角度偏差为4.12°±2.77°。种植体5年累计存留率为98.6%(143/145),145枚种植体中,种植相关生物并发症发生率为4.1%(6/145);修复相关机械并发症发生率为57%(13/23)。负荷5年后,边缘性骨吸收为(0.69±0.35) mm;患者对种植修复的效果满意。结论中老年患者在数字化导板辅助下行种植全口固定义齿修复的长期临床效果良好,患者满意度较高。Objective To evaluate long-term clinical outcome of implant-supported fixed prosthesis with the guidance of computer-aided design/computer-aided manufacturing(CAD/CAM)surgical template in old patients.Methods Fifteen 50-67(58.6±5.3)year-old patients(11 males and 4 females)who received the digital implant surgery with the guidance of CAD/CAM surgical template and implant-supported fixed prosthesis in Department of Oral Implantology,Yantai Stomatological Hospital Affiliated to Binzhou Medical College from August,2013 to Janurary,2016 were included.There are 15 edentulous maxillas,8 edentulous mandibles on which 145 implants were placed in total.After the placement of implant,the accuracy of CAD/CAM surgical template was assessed by comparing the post-operative 3-dimensional location of implant with the pre-operative design.The 5-year survival rate of implant and prosthesis was recorded,and marginal bone loss around implants and the development of complication were evaluated by radiological and clinical examination respectively.Results The result on accuracy of CAD/CAM surgical template showed that deviations in neck and apex of implants were(0.78±0.59)and(1.38±0.63)mm respectively,depth deviation was(0.65±0.35)mm and angle deviation was 4.12°±2.77°.The 5-year cumulative survival rate of implants was 98.6%(143/145).In all 145 implants,the prevalence of implant-related biological complication was 4.1%(6/145).The prosthesis-related mechanical complication rate was 57%(13/23).After 5-year function,mean peri-implant bone loss was(0.69±0.35)mm.Conclusions This 5-year follow-up retrospective study showed that implant-supported fixed prosthesis with the guidance of CAD/CAM surgical template in middle aged and elderly patients could achieve good long-term clinical outcome and patient satisfaction.

关 键 词：牙种植 数字化导板 无牙颌 长期稳定性 导板精度 

分 类 号：R783.6[医药卫生—口腔医学]