口内脉冲点焊技术用于下颌全牙弓种植即刻固定修复的两年疗效观察  

Immediate rehabilitation of edentulous mandibles with implant-supported full-arch prostheses by intra-oral welding technique:a two-year follow-up

作　　者：李莱 邸萍[1] 崔宏燕[1] 郝强[1] 林野[1] Li Lai;Di Ping;Cui Hongyan;Hao Qiang;Lin Ye(Department of Implantology,Peking University School and Hospital of Stomatology&National Center 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·口腔医院种植科,国家口腔医学中心,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12期1217-1223,共7页Chinese Journal of Stomatology

基　　金：首都卫生发展科研专项(首发2018-2-4102)。

摘　　要：目的探讨口内脉冲点焊技术用于下颌全牙弓种植即刻固定修复的2年临床效果,探究其相关技术特点。方法纳入2015年7月至2019年2月于北京大学口腔医学院·口腔医院种植科行下颌全牙弓种植即刻固定修复患者15例,其中男性4例,女性11例,年龄(64.2±9.3)岁。所有患者均于下颌植入4枚种植体后,使用口内脉冲点焊技术,将专用钛杆坚固焊接于种植体基台套管上,形成钛合金修复体支架;通过个性化预成修复体重衬于该支架上,完成下颌全牙弓即刻修复体。累计15例下颌骨(共60枚种植体)完成基台水平的全牙弓种植即刻固定修复。疗效观察指标包括:焊接支架-基台就位密合状态影像学检查、种植体存留情况、种植体边缘骨吸收、生物学并发症、机械并发症、修复体组织面清洁状况、问卷调查患者满意度。随访时间范围为24~55个月,平均34.9个月。结果15例焊接支架-基台就位顺利,临床及影像密合度良好,修复体连接固定顺利,至2年复查时60枚种植体中2枚种植体(2例患者)因骨结合丧失被取出,余58枚种植体边缘骨吸收量为(0.7±0.2)mm。存留的58枚种植体观察期内牙龈出血指数<3,未见明显牙龈红肿和瘘管等炎症表现。种植体无折裂变形等机械并发症,15件即刻固定修复体中6件发生人工牙脱落或修复体折裂机械并发症。修复体组织面清洁度不良,软垢评分(3.4±0.4)分。结论口内脉冲点焊技术用于下颌全牙弓种植即刻固定修复短期临床效果可预测,可较大程度地避免影响种植体间稳定连接的修复机械并发症,其即刻修复体有可能作为长期修复体使用,远期效果需继续随访观察。Objective To evaluate the 2-year clinical outcome of immediate loading implant-supported fixed full-arch prostheses in mandibles using intra-oral welding technique and to discuss the characteristics of the technique.Methods Totally 15 patients(4 males and 11 females)who treated with immediate rehabilitation of edentulous mandibles with implant-supported full-arch prostheses from July 2015 to February 2019 in Department of Implantology,Peking University School and Hospital of Stomatology were included in the present study.The patients′average age was 64.2±9.3 years.In each case,4 implants were placed in the mandible area,a titanium bar was connected with each of the implants by using intra-oral welding technique as the Ti-metal framework of the prostheses.Pre-fabricated abutment-level fixed prostheses were delivered immediately after the surgery.A total of 60 implants,15 mandibles were treated.Biological and mechanical complications,hygiene of the tissue-contacted surface of the restoration and patients′satisfactory grade were recorded.The radiological fitness of welded frameworks to abutments,survival rate of implants and marginal bone loss were calculated and analyzed.The observation period of the study was 24-55 months,with an average of 34.9 months.Results All of the 15 cases of welded bar-abutment frameworks were fixed on implants with well passive fitness in clinical and radiological level.However,2 of the 60 implants were failed by loss of osseointegration,and the result of implant survival rate of 96.7%in 2 years.The average marginal bone loss was(0.7±0.2)mm.The average bleeding index of the 58 implants remained was under 3 without clinical signs of gingival swelling,tenderness or fistula.No mechanical complications,such as break or distortion of the implants,occurred.Fracture of artificial teeth and complex resin area happened in 6 of the 15 prostheses.The average debris index was 3.4±0.4 and the hygiene of the tissue-contact areas was under satisfactory condition.Conclusions Using the intra-oral w

关 键 词：牙种植 口内脉冲点焊技术 全牙弓种植修复 即刻负荷牙种植体 

分 类 号：R783.6[医药卫生—口腔医学]