两种上部结构设计在前牙区种植修复的临床效果研究

目的:比较两种不同的上部结构设计在上颌前牙区单颗牙种植修复中的临床效果。方法:选择连续于我科就诊的57例上颌前牙区单颗牙种植修复患者,按照种植体长轴分为两组,A组26例长轴位于牙冠切端舌侧至舌隆突之间,上部结构设计为低边缘钛基台和舌侧开孔的氧化锆全瓷冠,戴牙前于体外预先粘结;B组31例长轴位于牙冠切端或唇侧,设计为个性化氧化锆基台和氧化锆全瓷冠,于口内常规粘结。戴牙当天和修复后12个月复诊时记录红色美学指数(pink esthetic score,PES),并于12个月复诊时检测种植体周围边缘骨吸收量(marginal bone loss,MBL)、改良菌斑指数(modified plaque index,mPI)、改良出血指数(modified sulcus bleeding index,mSBI)及各种机械并发症。结果:戴牙当天和复诊时两组PES差异均无统计学意义;修复后12个月,两组PES值均高于戴牙当天(P<0.05);两组MBL、mPI、mSBI值差异均无统计学意义。A组未发生机械并发症;B组出现2例钛基台与氧化锆穿龈结构之间松脱。结论:两种上部结构设计在上颌前牙区单颗牙种植修复中均能取得良好的效果,临床上可以根据病例具体情况选择。

A study on clinical outcomes of two types of implant-supported superstructures in anterior region

Objective:To compare the clinical outcomes of two types of implant-supported superstructures in anterior region.Methods:A total of 57 consecutive single tooth missing patients who accepted dental implant therapy in anterior region were chosen for this study,and divided into two groups according to the implant axial direction.The implant axial direction in group A 26 patients was between incisal edge and lingual eminence,and the direction in group B 31 patients was right through incisal edge or even the labial surface.The superstructures in group A were low margin Ti-abutment and zirconia all-ceramic crown with lingual foramen,and the superstructures in group B were customized abutment and zirconia all-ceramic crown.Pink esthetic score(PES)was recorded at the day restoring final superstructure and 12-month recall.Marginal bone loss(MBL),modified plaque index(mPI),modified sulcus bleeding index(mSBI),and the mechanical complications were recorded at 12-month follow-up.Results:PES at the day restoring final superstructure and 12-month recall between two groups had no significant difference respectively.PES at the day restoring final superstructure and 12-month recall in group A had significant difference,so did PES in group B.At 12-month recall,the mean value of MBL,mPI and mSBI had no significant difference between two groups.There was no mechanical complication in group A,but two cases of mechanical complication were observed in group B.Conclusion:Two types of implant-supported superstructures described in the present study both achieve good clinical outcomes,choice should be made according to the situation of the specific case.