All-on-four无牙颌固定义齿修复的临床研究

发布时间：2018-04-05 02:34

本文选题：无牙颌　切入点：all-on-four　出处：《青岛大学》2017年硕士论文

【摘要】：目的:临床研究all-on-four无牙颌固定义齿的种植及修复的方法以及与植入相同种植体颗数的种植覆盖义齿相对比,观察种植体及上部修复体成功率、种植体牙周健康(包括种植体周围菌斑指数及探针出血指数)、咀嚼效率测定、患者满意度调查及种植体周围骨高度变化6个方面。方法:临床收集无牙颌患者,制作普通全口义齿,如固位力、稳定性等不能满足患者需求,则按照all-on-four术式制作种植固定义齿修复或进行4颗种植支持覆盖义齿修复。将all-on-four固定修复患者设为A组,植入4颗种植体行覆盖义齿修复患者设为B组。两组分别按照如下方法进行研究:术前设计及制作CAD/CAM导板,在数字化导板的引导下A、B两组分别进行种植手术。A组按照all-on-four术式将4颗种植体植入患者颌骨内,24h内为患者制作种植体支持式临时义齿,经过3-6月的骨结合后行永久修复。B组在导板的定位下将4颗种植体植入患者颌骨内,经过3-6月的骨结合,制作种植体支持式覆盖义齿。对上述A、B两组患者进行临床观察:永久修复1个月后对两组患者分别进行满意度调查。永久修复12个月后对两组患者分别进行种植体及修复体成功率、种植体牙周健康(包括种植体周围菌斑指数及探针出血指数)、咀嚼效率测定及种植体周围骨高度变化的检测。结果:1.按照all-on-four术式在患者前牙区植入2颗轴向种植体,远中植入2颗倾斜种植体,利用4颗种植体支持的单颌螺丝固位一段式固定桥。只需要种植4颗种植体即可实现无牙颌固定修复,减轻患者的手术创伤及费用。在种植手术当天患者即可戴入种植体支持式临时义齿,解决了种植体愈合期内患者无牙的情况。提高了患者的生活质量。2.永久修复1个月后,对患者进行义齿满意度问卷调查,问卷调查显示,与植入相同数目种植体的种植覆盖义齿相比,all-on-four无牙颌种植固定修复在咀嚼、舒适、方便及发音方面得分高于种植覆盖义齿,差异有统计学意义(P0.05)。3.永久修复12个月后,对两组患者进行种植体及修复体成功率、种植体牙周健康(包括种植体周围菌斑指数及探针出血指数)、咀嚼效率测定及种植体周围骨高度变化的监测,结果A、B两组在种植体及修复体成功率、种植体牙周健康、种植体周围骨高度变化方面A、B两组差异无统计学意义(P0.05),对A、B两组进行咀嚼效率测定结果显示A组高于B组,差异有统计学意义(P0.05)。结论:1.All-on-four无牙颌种植修复技术只需植入4颗种植体即可实现无牙颌固定修复。2.All-on-four无牙颌种植修复技术与种植体支持式覆盖义齿修复相比,得到较高的咀嚼效率和患者满意度。3.All-on-four无牙颌种植修复技术与种植体支持式覆盖义齿修复相比,在种植体及其上部修复体成功率、种植体牙周健康(包括种植体周围菌斑指数及探诊出血指数)及种植体周围骨高度变化方面差异无统计学意义。
[Abstract]:Objective: to investigate the methods of implant and repair of all-on-four denture and compare with the same number of implants to observe the success rate of implants and upper implants.Implant periodontal health (including plaque index and probe bleeding index), masticatory efficiency measurement, patient satisfaction survey and bone height changes around the implant.Methods: the patients with edentulous jaws were collected clinically, and general complete dentures were made. If the retention and stability could not meet the needs of the patients, the implant fixed dentures or 4 implant-supported overdentures were made according to the all-on-four procedure.Group A was fixed with all-on-four and group B was implanted with 4 implants for overdenture.The two groups were studied according to the following methods: preoperative design and fabrication of CAD/CAM guide plate,Under the guidance of digital guide plate, group A and group A were respectively treated with implant operation. Group A made implant-supported temporary dentures for patients within 24 hours according to all-on-four procedure.Four implants were implanted into the jaws of the patients after 3 to 6 months of bone bonding. The implant-supported overdentures were made in group B under the guidance of the guide plate.The clinical observation was carried out in the above two groups: one month after permanent repair, the satisfaction of the two groups were investigated.After 12 months of permanent restoration, implant and prosthesis success rate, periodontal health (including plaque index and probe bleeding index), masticatory efficiency and bone height around implant were measured.The result is 1: 1.According to all-on-four procedure, two axial implants and two oblique implants were implanted in the anterior teeth of the patients, and 4 implants supported by single jaw screws were used to maintain a fixed bridge.Only 4 implants can be used to repair edentulous jaw and reduce the surgical trauma and cost.Implant-supported temporary dentures can be worn on the day of implant implantation, which solves the problem of dental absence during the healing period of implants.Improved the patient's quality of life.A month after permanent restoration, a questionnaire survey on denture satisfaction showed that the all-on-four dental prosthesis was chewed and comfortable compared with the implant overdenture with the same number of implants.The scores of convenience and pronunciation were higher than that of implant overdenture, and the difference was statistically significant (P 0.05).After 12 months of permanent restoration, implant and prosthesis success rate, periodontal health (including plaque index and probe bleeding index), masticatory efficiency and bone height around implant were measured.Results there was no significant difference in the success rate of implant and prosthesis, the periodontal health of implant and the change of bone height around implant between two groups (P 0.05). The masticatory efficiency of group A was higher than that of group B (P 0.05), and the masticatory efficiency of group A was higher than that of group B.The difference was statistically significant (P 0.05).Conclusion: 1. All-on-four dental prosthesis can be implemented with only 4 implants. 2. All-on-four dental prosthesis is compared with implant-supported overdenture.Higher masticatory efficiency and patient satisfaction. 3. All-on-four dental prosthesis technology compared with implant-supported overdenture, the success rate of implants and their upper implants,There was no significant difference in periodontal health (including plaque index and bleeding index) and bone height around implant.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.6

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