后牙种植单冠修复后局部咬合变化的四年前瞻性临床研究  

Occlusion variation of posterior implant-supported single crown: a prospective 4-year follow-up study

作　　者：丁茜[1] 罗强[2] 李晓利[3] 张磊[1] 谢秋菲[1] Ding Qian;Luo Qiang;Li Xiaoli;Zhang Lei;Xie Qiufei(Department of Proshodontics,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,China;Department of Operative Dentistry and Endodontics,General Hospital of Chinese PLA,Beijing 100853,China;Denture Processing Center,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,China)

机构地区：[1]北京大学口腔医学院·口腔医院修复科,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,100081 [2]解放军总医院口腔内科,北京100853 [3]北京大学口腔医学院·口腔医院义齿加工中心,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,100081

出　　处：《中华口腔医学杂志》2021年第3期244-250,共7页Chinese Journal of Stomatology

基　　金：国家自然科学基金(81671026);首都卫生发展科研专项(首发2020-2-4104);北京市自然科学基金(7192233)。

摘　　要：目的定量分析后牙种植单冠修复后4年患者口内局部力分布与咬合时间的变化规律,为种植修复体的咬合设计、调整和长期维护提供参考。方法前瞻性收集2012年12月至2013年12月于北京大学口腔医学院·口腔医院修复科行后牙种植单冠修复的患者,分别于修复后2周和3、6个月以及1、2、3、4年复查,采用咬合纸和数字化咬合分析系统检查咬合,记录种植单冠、近中邻牙和对照牙(种植单冠同颌对侧同名牙)的力百分率以及种植单冠咬合时间比(种植单冠咬合时间与牙列咬合时间的比值)。同时,通过牙线和金属邻接触检查片检查种植单冠邻接触情况,并记录种植修复相关机械并发症。采用患者自身前后对照,选取同时具备相邻随访时间点结果的患者数据,分析种植单冠、近中邻牙、对照牙力百分率以及种植单冠咬合时间比的相邻随访时间点差异;统计所有数据,比较相同时间点种植单冠与对照牙力百分率的差异。应用“对数-补对数”模型,以性别、年龄、修复时间为控制变量,分析修复体饰面瓷材料破损与否与种植单冠力百分率的相关关系。结果共纳入33例患者,其中男性16例,女性17例,年龄(42.8±12.9)岁(23.9~70.0岁);共纳入37件种植单冠,随访(38.3±15.2)个月。修复后2周至3个月种植单冠力百分率从(7.0±4.2)%显著增加至(9.9±6.8)%(P<0.05),对照牙力百分率则从(13.1±6.1)%显著减少至(11.4±5.5)%(P<0.05);修复后1、2、3年种植单冠力百分率均显著大于前一时间点(P<0.05)。修复后3和6个月种植单冠咬合时间比分别显著大于前一时间点(P<0.05),其余各时间点与前一时间点的咬合时间比差异均无统计学意义(P>0.05)。相同时间点的比较中,修复后2周种植单冠力百分率[(7.5±4.2)%]显著小于对照牙[(13.8±6.0)%](P<0.01),修复后4年种植单冠力百分率[16.7%(8.6%,32.4%)]显著大于对照牙[9.5%(4.9%,18.0%)](P<0.05);其余各时�Objective To analyze the longitudinal variation of occlusal force distribution and occlusal contact time in posterior implant-supported single crown with the computerized occlusal analysis system.Methods Partially edentulous patients who visited the Department of Prosthodontics,Peking University School and Hospital of Stomatology between December 2012 and December 2013,and had received implant-supported single crown in the posterior region were enrolled.The participants underwent occlusal examinations with the computerized occlusal analysis system at 2 weeks,3 and 6 months,1,2,3,and 4 years after implant prosthesis delivery.The relative occlusal force(ROF)of implant prostheses,mesial adjacent teeth,and control teeth(corresponding teeth on the contralateral side)were recorded,and implant prosthesis occlusion time ratios(implant prosthesis occlusion time/occlusion time)were calculated.The interproximal contact between implant prostheses and adjacent teeth was evaluated using metal contact gauge and dental floss.Mechanical complications of implant prostheses were recorded.The paired t test or Wilcoxon signed-rank test was used to compare the implant prosthesis occlusion time ratios and ROF of implant prostheses at 2 different times as a self-control.The differences in ROF between implant prostheses and control teeth in the same participant at the same time were also analyzed using paired t test.Using a complementary log-log model,the correlation between the occurrence of veneering material fracture and ROF of implant prosthesis was analyzed with gender,age and follow-up time as the control variables.Results Thirty-seven posterior fixed implant-supported single crowns in 33 participants,including 16 men and 17 women aged(42.8±12.9)years(23.9 to 70.0 years)were followed up for 2 weeks to 4 years[(38.3±15.2)months].The ROF of implant prostheses increased significantly(P<0.01)from 2 weeks[(7.0±4.2)%]to 3 months[(9.9±6.8)%],whereas those of control natural teeth decreased significantly(P<0.05)from(13.1±6.1)%to(11.4�

关 键 词：牙种植体 单牙 咬合力 纵向研究 咬合时间 

分 类 号：R783.6[医药卫生—口腔医学]