平台转换连接与对接连接在即刻功能性负重中的对比研究

发布时间：2018-09-15 06:32

【摘要】：目的：评价平台转换连接与对接连接种植体即刻功能性负重后短期内的边缘骨丧失情况并探讨种植体即刻功能负重成功率的影响因素,同时观察两组的牙龈变化情况。方法：选择因外伤根折、牙体缺损、牙周疾病无法保留的上下前牙、第一双尖牙为观察对象,拔除后行即刻种植且功能性负重的患者50例,采用随机分组对照方式,根据种植体-基台连接设计不同分为两组,平台转换组25例采用平台转换连接技术的Nobel Active种植体；对接连接组25例,采用对接连接技术的Nobel Replace种植体。两组患者种植术后即刻戴入临时冠行功能性负重,12个月后更换为永久修复体。所有病例进行影像学检测(包括CT、全景片、根尖片),通过影像学检测评估两种连接方式的种植体边缘骨的吸收情况并同时观察两组的牙龈位置变化情况。结果：两组种植体均完成骨及软组织的结合,随访期内,种植体无松动、脱落,牙龈组织健康,成功率均为100%。上下前牙拔除后将平台转换连接技术应用于即刻种植且即刻功能性负重的短期临床效果较佳,平台转换连接种植体与对接连接种植体功能性负载12个月时测量得到的种植体边缘骨吸收的均值相比较,平台转换组的骨吸收为1.09±0.62mm,对接连接组的骨吸收为1.43±0.62,P0.05,平台转换连接种植体较对接连接种植体的边缘骨吸收的数值均值稍低,但两组无明显统计学差异。平台转换组与对接连接组的牙龈位置：术后戴入临时树脂冠时测量均3mm,平台转换组3月后基本恢复正常,探诊深度减小到3mm以内,临时冠戴入12个月时平台转换组的PD为2.68mm,对接连接组的PD为2.98mmm,P0.05,差异有统计学意义,可以认为平台转换组的牙龈健康状况优于对接连接组。结论：本研究将平台转换技术应用于即刻种植且功能性负重时短期内种植体颈部边缘骨的吸收同对接连接虽然无明显差异,但牙龈探诊深度优于对接连接,其成功率高并可获得令人满意的临床效果,具有较高的临床应用价值。
[Abstract]:Objective: to evaluate the short-term loss of marginal bone in the implants with immediate functional load and to investigate the influencing factors of the success rate of immediate functional load of the implants, and to observe the gingival changes of the two groups. Methods: the upper and lower anterior teeth which could not be preserved due to traumatic root fracture, tooth defect and periodontal disease were selected as observation objects. The first canine teeth were implanted immediately after extraction, and 50 patients with functional load were randomly divided into two groups. According to the design of implant-base connection, the two groups were divided into two groups: the platform conversion group (25 cases) using the platform conversion connection technique (Nobel Active), and the docking connection group (25 cases) the Nobel Replace implants using the docking connection technique. The patients in both groups were put on temporary crown immediately after implantation and replaced with permanent prosthesis 12 months later. All cases were examined by imaging (including CT, panorama and apical radiography). The resorption of the marginal bone of the implants in two ways of connection was evaluated and the gingival position of the two groups was also observed at the same time. Results: bone and soft tissue were combined in both groups. During the follow-up period, there was no loosening, abscission, healthy gingival tissue, and the success rate was 100%. After the extraction of the upper and lower anterior teeth, the platform-switching connection technique was applied to the short-term clinical effect of immediate implant and immediate functional load. The mean value of bone resorption at the edge of the implants measured at 12 months of functional loading between the platform-switched connective implants and the docking implants was compared. The bone resorption was 1.09 卤0.62mm in the platform-transition group and 1.43 卤0.62p0.05 in the docking connection group. The mean value of bone resorption in the platform-switched implant was slightly lower than that in the marginal bone resorption, but there was no significant difference between the two groups. The gingival position of the platform transition group and the docking connection group: the gingival position was 3 mm when the temporary resin crown was put on after operation, and it returned to normal after 3 months in the platform conversion group, and the probing depth was reduced to less than 3mm. The PD of the platform transition group was 2.68 mm, and the PD of the docking connection group was 2.98 mm (P0.05) at 12 months after the temporary crown was worn. The difference was statistically significant. It can be concluded that the gingival health status of the platform transition group is better than that of the docking connection group. Conclusion: although there is no significant difference between the resorption and docking connection of the marginal bone of the implant in the short term, the depth of gingival probing is better than that of the docking connection. It has high success rate and satisfactory clinical effect, and has high clinical application value.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6

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