“All-on-4”无牙颌种植即刻修复技术的初步临床观察

发布时间：2018-05-12 12:55

本文选题：颌 + 无牙　；参考：《北京大学学报(医学版)》2014年05期

【摘要】：目的:回顾性评估"All-on-4"即刻修复技术的临床效果。方法:根据纳入及排除标准,本研究共纳入40例"All-on-4"患者。所有患者均采用4枚种植体支持的螺丝固位的即刻修复方案,共植入196枚种植体,对该修复方案下的种植体留存率、修复体留存率、种植1年后种植体边缘骨吸收情况、患者修复并发症进行归纳及分析。结果:在40例患者中,共有13枚种植体失败,其上颌种植体失败11枚,上颌留存率为85.5%(65/76),下颌种植体失败2枚,下颌留存率为98.3%(118/120)。垂直植入种植体失败5枚,留存率为95.0%(93/98);角度植入种植体失败8枚,留存率为91.8%(90/98)。修复体留存率为95.9%(47/49)。所有于下颌的角度植入种植体边缘骨吸收的中位数0.60 mm,垂直植入的种植体边缘骨吸收的中位数为0.60 mm,Wilcoxon检验结果显示其1年后的骨吸收量差异无统计学意义(P0.05)。上颌骨倾斜植入的种植体1年后边缘骨吸收的中位数为0.60 mm,垂直植入种植体的1年后边缘骨吸收的中位数为0.55 mm,Wilcoxon检验结果显示二者差异并无统计学意义(P0.05)。通过患者的病例回顾发现有20个修复体出现过不同程度的机械并发症,包括人工牙脱落、基台螺丝松动、义齿基托折裂和基台螺丝折裂等。结论:"All-on-4"无牙颌即刻修复近期临床效果可靠,该技术的远期效果和技术细节对效果的影响等还需更多大样本的临床随机对照研究和长期临床观察。
[Abstract]:Objective: to evaluate retrospectively the clinical effect of immediate repair of All-on-4. Methods: according to the criteria of inclusion and exclusion, 40 patients with All-on-4 were included in this study. A total of 196 implants were implanted with 4 implant-supported immediate prostheses. The retention rate of implants, the retention rates of implants, and the bone resorption at the edge of the implants after one year of implantation were analyzed. The complications of repair were summarized and analyzed. Results: of the 40 patients, 13 implants failed. The maxillary implants failed 11, the maxillary retention rate was 85. 5% 65 / 76, the mandibular implants failed 2, and the mandibular retention rate was 98. 38 / 120. Five vertical implants failed, the retention rate was 95.0 / 93 / 98, and the angle implant failed 8, the retention rate was 91.890 / 98. The retention rate of restoration is 95.9%. The median of bone resorption was 0.60 mm in all mandibular angle implants and 0.60 mm in vertical implants. The results of Wilcoxon test showed that there was no significant difference in bone resorption after one year. The median of marginal bone resorption was 0.60 mm in maxillary oblique implants and 0.55 mm in vertical implants one year later. The results of Wilcoxon test showed that there was no significant difference between the two groups (P 0.05). A retrospective study of 20 prostheses showed different degrees of mechanical complications, including tooth loss, loosening of abutment screws, denture base fracture and abutment screw fracture. Conclusion: the immediate restoration of "All-on-4" edentulous jaw is reliable in the near future. The long-term effect of this technique and the influence of technical details on the effect need more clinical randomized controlled study and long-term clinical observation.
【作者单位】：北京大学口腔医学院·口腔医院种植科;
【分类号】：R783.6

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