氧化锆全瓷修复体在后牙种植区应用的临床回顾性研究

发布时间：2018-12-15 07:07

【摘要】：近年，随着口腔材料的发展，氧化锆逐步取代烤瓷熔附金属、氧化铝等修复材料，成为修复领域中具有广阔发展前景的生物材料。氧化锆具有较高的机械强度，挠曲强度达到900-1200Mpa，抗压强度达到2000Mpa，化学性能稳定，又由于氧化锆生物相容性良好、制作精度高、不影响磁共振成像、强度大等诸多优点而广泛地应用于口腔临床。用于前牙的美学修复时，具有明显的美学优势。但是，应用于后牙时，其临床效果受到材料相关的并发症的影响，目前，是否推荐用于后牙冠修复尚未有定论，尤其在种植领域，相关的临床研究尚不多见。而且氧化锆本身具有刚性，没有与金属或烤瓷熔附金属修复体一样对咬合存在逐渐适应的过程，若处于后牙区咬合力量大的位置，在长期的循环负载过程中，可能会增加氧化锆全瓷修复出现并发症的风险。再加上种植体根部缺少类似牙周韧带的组织，对咬合力缺乏缓冲机制，导致种植体周围骨组织受到一定应力，而可能发生骨水平的改变。因此，，氧化锆全瓷运用于后牙种植修复的效果及其对种植体周围组织健康的影响是值得研究的一项课题。实验一氧化锆全瓷修复体在后牙种植区应用的临床效果评价目的:本实验通过回顾性研究在后牙种植区完成氧化锆全瓷修复的临床和影像学资料，评价氧化锆全瓷修复应用于后牙种植的临床使用效果。方法:本研究收集自2011年07月至2012年06月陕西省内在第四军医大学口腔医院种植科采用氧化锆全瓷进行后牙种植修复的临床病例和影像学资料，对323位患者（387个修复体，528颗种植体）进行回顾性研究。检查修复体完整性、密合性、牙龈状况，检测改良龈沟出血指数（mSBI）、改良菌斑指数（mPLI）、牙周探诊深度（PD），详细记录种植体和修复体的存留状况。使用SPSS18.0对数据进行统计分析。结果:随访患者264位（81.7%），修复体315个（81.4%），种植体423颗（80.1%）。平均随访时间18.8±3.8个月（12～28个月）。修复体机械并发症总体发生率8.0%。24个修复体（9.1%）发生崩瓷，1个修复体（0.3%）发生脱落。种植体累计存留率100%。随访期内未发现种植体发生松动、折断、脱落。改良龈沟出血指数（mSBI）平均值0.45±0.78（0～3），改良菌斑指数（mPLI）平均值0.35±0.73（0～3），PD平均值2.74±1.08mm（1～7mm）。14颗（3.3%）种植体出现种植体周围粘膜炎表现。结论:种植单冠支持的氧化锆全瓷修复后牙单牙缺失可以达到良好的修复效果。但是，由于全氧化锆瓷不存在瓷层结合强度等问题，而且强度高，若患者不考虑美观，则推荐用于后牙多牙连续缺失的修复。实验二后牙种植区氧化锆全瓷修复影响种植体边缘骨吸收的临床研究目的:探讨氧化锆全瓷修复的相关受力因素对种植体边缘骨吸收的影响。方法:收集自2011年07月至2012年06月陕西省内在第四军医大学口腔医院种植科采用氧化锆全瓷进行后牙种植修复的临床病例和影像学资料，对323位患者（387个修复体，528颗种植体）进行回顾性研究。分别测量戴牙当日和随访当日的X线片中种植体周围边缘骨水平至基台平面的垂直距离，获得该时间段内边缘骨水平的变化。使用多元线性回归分析种植体边缘骨吸收的影响因素。结果:种植体从功能负载后一年至随访时间，MBL平均值（0.28±0.35）mm，最大值1.97mm，最小值0mm。通过多元回归分析，种植修复方式（P=0.023）和对颌牙类型（P=0.030）对MBL有影响。进一步分析，对颌为自然牙的种植单冠的种植体品牌（P=0.016），种植联冠的种植体位置（P=0.021）、修复体崩瓷情况（P=0.004）、牙周病史（P=0.035），种植固定桥的种植体位置（P=0.006）可能影响MBL。不同对颌类型的MBL的差异可能受到年龄、种植体位置、品牌等变量的影响。结论:在氧化锆全瓷修复的咬合受力下，种植体周围未发生损伤性的边缘骨吸收。种植修复方式和对颌牙类型是MBL的影响因素。在探诊出血以及上颌磨牙的种植体中，种植联冠相对种植单冠的边缘骨吸收更多。对颌种植固定义齿的种植体边缘骨吸收高于对颌自然牙的种植体。在上颌straumann种植体中，这种差异更明显。
[Abstract]:In recent years, with the development of oral material, the oxidation of the metal, alumina and other repair materials has become a promising biomaterial in the field of repair. the oxidizing agent has higher mechanical strength, the flexural strength reaches 900-1200Mpa, the compressive strength reaches 2000Mpa, the chemical property is stable, and the oxidizing agent has the advantages of good biocompatibility, high manufacturing precision, no influence on magnetic resonance imaging, large intensity and the like, and is widely applied to the oral clinic. When used for the aesthetic restoration of the front teeth, the invention has the obvious aesthetic advantage. However, when applied to the posterior teeth, its clinical effect is affected by the material-related complications. At present, it is not clear whether it is recommended for posterior dental crown repair, especially in the field of planting. and the oxidizing agent itself has the rigidity, does not have the process of gradually adapting to the bite due to the metal or porcelain fused metal repairing body, and if the position of the biting force of the posterior tooth area is large, the process of the long-term cyclic loading In addition, it is possible to increase the wind of the complication of the whole-ceramic restoration of the oxidized silicon oxide. Risk. Combined with the absence of a tissue similar to the periodontal ligament at the root of the implant, the lack of a cushioning mechanism to the biting force results in a certain stress on the bone tissue surrounding the implant, which may lead to a change in the bone level Therefore, the effect of the application of the full-ceramic oxide on the restoration of the post-implant and its effect on the health of the surrounding tissue of the implant is one of the lessons to be studied A clinical study on the application of a full-ceramic restoration in the posterior tooth-growing area Objective: To evaluate the clinical and imaging data of the complete porcelain restoration in the post-dental implant area, and to evaluate the application of the full-ceramic restoration in the post-dental implant to the post-dental implant. Methods: This study collected the clinical and imaging data from July 2011 to June 2012 in the Department of Stomatology of the Fourth Military Medical University in Shaanxi Province. The clinical and imaging data of the restoration of post-dental implant in the Department of Stomatological Hospital of the Fourth Military Medical University were carried out in Shaanxi Province, and 323 patients (387 restorations, 528 implants) were collected. A retrospective study was performed to examine the integrity, adhesion, and gingival conditions of the prosthesis, the modified gingival crevicular index (mSBI), the modified plaque index (mPLI), the depth of the periodontal examination (PD), and the detailed recording of the implant and repair. The persistence of the complex. Using the SPSS18. 0 log Results: 264 patients (81.7%) and 315 (81.4%) of the patients were followed up, and the implant 42 3 (80.1%). The average follow-up time was 18. 8 to 3. 8 months. (12-28 months). The overall incidence of repair mechanical complications was 80.0%. 0. 3%) Dropped. Implant The cumulative retention rate was 100%. The implant was not found during the follow-up period The mean value of modified gingival crevicular index (mSBI) was 0.45-0.78 (0-3), the modified plaque index (mplI) was 0.35-0.73 (0-3), the average of PD was 2.74-1.08mm (1-7mm), and 14 (3. 3%) implants appeared. The results of the surrounding mucositis of the implant body. Conclusion: The single-tooth missing tooth is missing after the full-ceramic restoration with single-crown support. good repair effect can be achieved, The repair of the continuous deletion of the posterior teeth with multiple teeth. The purpose of the clinical study of the bone resorption in response to the edge of the implant: to study the correlation of the full-ceramic repair of the oxide The effect of the force factor on the bone resorption of the implant was collected from July 2011 to June 2012. The clinical and imaging data of the post-dental implant repair in the Department of Stomatology of the Fourth Military Medical University in Shaanxi Province from July 2011 to June 2012 were collected, and 323 patients (387 were repaired) A retrospective study of the body, 528 implants). The vertical spacing of the peri-implant peripheral edge bone level to the base platform plane on the day of the day of wear and the date of follow-up, respectively, was measured. A change in the level of the edge bone in the time period is obtained. Multiple linearity is used Regression analysis of the effects of implant-edge bone resorption. Results: The mean time of the implant from the functional load to the follow-up time and the mean value of MBL (0.28-0.35) mm, max. 1.97mm, min. 0mm. Through multiple regression analysis, planting repair (P = 0.023) and jaw The dental type (P = 0.030) has an effect on MBL. Further analysis, the implant brand (P = 0.016), the implant position of the crown (P = 0.021), the repair body collapse (P = 0. 004), the history of periodontal disease (P = 0.035) and the planting of the fixed bridge were also analyzed. Body position (P = 0. 006) may affect the MBL. The difference in MBL of the different pair of jaw types may The effects of age, implant location, brand, etc. Conclusion: The occlusion of the full-ceramic repair of the oxidized silicon At the force of the implant, there was no marginal bone resorption around the implant. Planting and repairing methods and the influence factors on the type of the jaw teeth are MBL. In the diagnosis and diagnosis of bleeding and the planting of the maxillary molars In the body, the crown of the plant is more absorbed by the marginal bone of the single crown. The implant marginal bone of the tooth is higher than the implant for the natural tooth of the jaw. In the upper jaw
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6

【共引文献】