不同愈合方式的种植体临床效果的回顾性分析

发布时间：2018-07-25 12:27

【摘要】：目的:评价埋入式种植体和非埋入式种植体修复牙列缺损的短期临床效果,同时评估影响种植体上部结构及周围组织稳定性的各种临床因素。分析不同愈合方式种植修复体冠根比和种植体周围炎症病史等因素与种植体周围边缘骨吸收之间的关系,为临床工作中种植体的使用及维护上部结构的设计提供参考依据,提高其临床效果和远期成功率。方法:临床采用非埋入式种植体和埋入式种植体对178例患者实施215枚人工种植体,其中包括非埋入式种植体82枚、埋入式种植体133枚,修复前后,随访36个月,在冠修复当天及修复后第6、12、24、36个月后分别进行曲面断层片检查。测量下颌后牙区单颗牙缺失的患者曲面断层片中种植体边缘牙槽骨高度和冠根比值,计算牙槽骨丧失高度。用SPSS17.0软件进行统计分析。结果:年龄小于55岁的患者最多,为170例,占79.81%,种植部位下颌多于上颌,下颌后牙区最多,为115例,占53.48%。不同的固位方式出现修复体机械性并发症的发生率有明显差异,其中螺丝固位的种植体发生机械性并发症的发生率为19.35%,相应粘结固位的发生率为7.27%,全部植体冠部结构的成功率为90.70%。回顾3年种植体的失败率为1.81%,种植牙失败的原因可能是植体选择不当、早期咬合创伤、不良生活习惯等。下颌后牙区单颗牙缺失的病例中,CRR在不同愈合方式间差异不显著;在不同愈合方式下植体植入3年后种植体周围骨组织骨吸收量呈不断增长趋势,不同愈合方式的植体增长幅度不同;非埋入式植体组边缘骨吸收量在冠修复当天,修复后6个月均明显大埋入式植体组(P0.05);埋入式植体组边缘骨吸收量在修复后12个月时骨吸收量大非埋入式种植体组(P0.05),在修复后24、36个月时,二者之间无明显差异。两种愈合方式的植体3年累计存留率分别为98.74%和97.74%,差异无统计学意义(P0.05)。结论:认为术前严格检查,综合各因素分析选择好适应证,术中规范操作,术后避免早期咬合创伤,同时指导患者掌握正确的维护方法是种植成功的前提保障。CRR在不同愈合方式间差异不显著,两种愈合方式对种植体周围骨组织吸收的影响不同,但都有较好的临床疗效。
[Abstract]:Objective: to evaluate the short-term clinical effects of implants and non-implants in the restoration of dentition defects, and to evaluate the clinical factors affecting the stability of the superstructure and surrounding tissues of the implants. To analyze the relationship between the ratio of crown to root and the history of peri-implant inflammation and bone resorption around implants in different healing modes of implants, to provide a reference for the use of implants and the design of superstructure maintenance in clinical work. Improve its clinical effect and long-term success rate. Methods: a total of 215 implants, including 82 implants and 133 implants, were performed on 178 patients with non-embedded implants and implants. The patients were followed up for 36 months. On the day of crown restoration and at the 612 ~ (th) ~ (th), 36 months later, the surface tomograms were examined respectively. The height of alveolar bone and the ratio of crown and root were measured in curved surface tomograph of patients with single missing tooth in mandibular posterior region to calculate the height of alveolar bone loss. Statistical analysis was carried out with SPSS17.0 software. Results: 170 cases (79.81%) were less than 55 years old. The implant site had more mandible than upper jaw and 115 cases (53.48%) had lower posterior teeth. There were significant differences in the incidence of mechanical complications in different retainers. Among them, the incidence of mechanical complications in screw retainer implant was 19.355.The incidence of adhesive retention was 7.27. The success rate of all implant crown structure was 90.70. The failure rate of implant in 3 years was 1.81%. The reasons of dental implants failure may be improper selection of implant, early occlusal trauma, bad living habits and so on. There was no significant difference in CRR among the patients with single tooth loss in the mandibular posterior region, and the bone resorption of the bone tissue around the implant showed an increasing trend after 3 years of implant implantation in different healing modes. The amount of bone resorption at the edge of the non-embedded implant group was the same as that in the crown repair group. The bone resorption of the implant group was significantly larger than that of the control group at 12 months after repair (P0.05), but there was no significant difference between the two groups at 24 and 36 months after repair. The accumulative survival rate of the two kinds of healing methods were 98.74% and 97.74% respectively, the difference was not statistically significant (P0.05). Conclusion: strict examination before operation, comprehensive analysis of various factors, selection of indications, standard operation during operation, prevention of early occlusal trauma after operation, At the same time, guiding the patients to master the correct maintenance method is the premise of successful implants. CRR has no significant difference among different healing modes. The two healing modes have different effects on the bone tissue absorption around the implant, but both have good clinical effect.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.6

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