重度牙周炎患者种植总义齿修复的临床观察

目的:探讨重度牙周炎患者拔除余留牙后行种植总义齿修复的临床疗效。材料和方法:重度牙周炎患者18位,拔除单颌所有余留牙后即刻或4～6周后植入种植体,采用即刻负重或延期负重的修复方式,并于术后3～8月后完成最终种植总义齿的修复。对所有患者进行临床及X线检查评价修复效果。结果:18位患者共植入144颗种植体,共完成24个种植总义齿的修复,其中上颌14例,下颌10例,12例采用了即刻负重的方式,12例3～8个月后延期负重。最终9例行固定总义齿修复,15例行覆盖义齿修复。永久修复完成后随访10～36个月,平均13个月。观察期内共2颗种植体丧失。修复完成后6个月时与植入时相比,种植体周边缘骨吸收0.56mm。采用覆盖义齿或固定义齿,种植体边缘骨吸收无明显差异。讨论:对于临床预后不佳的重度牙周炎患者,早期拔除余留牙后采用种植总义齿的修复方式,可早日恢复患者的咀嚼功能。严格的适应症选择,合理的治疗设计及正确的手术实施是保证成功率的关键。结论:对重度牙周炎患者采用种植总义齿的修复方式可获得满意的临床效果。

Clinical evaluation of implant-supported full dentures for patients suffered severe periodontitis

Purpose： To evaluate the efficacy of implant-supported full dentures for the treatment of severe periodontitis patients.Material and methods： All of the remaining teeth in upper or lower jaw were extracted in 18 patients suffered severe periodontitis.Implants were inserted immediately or 4 to 6 weeks after teeth extraction.Immediate or delayed loading were used for all the patients.The final restorations were made 3 to 8 months later.Clinical and radiographic examinations were made for all the patients regularly.Results： 144 implants were placed in 18 patients.24 implant-supported full dentures were made,14 for the upper jaws and 10 for the lower jaws.Immediate loading was used for 12 jaws.Fixed dentures were used for 9 jaws and removable overdentures were used for 15 jaws.The mean follow-up time for all of the patients was 13 months （range,10 to 36 months）.2 implants were lost during follow-up time.But all of the dentures functioned well.The mean reduction in marginal bone height over the 6-month observation period was 0.56 mm.There is no obvious difference of the reduction in marginal bone height between overdentue group and fixed denture group.Discussions： The method of implant-supported full denture is beneficial for severe periodontitis patients to acquire normal mastication function earlier.Proper indication selection,reasonable treatment plan and correct operation manipulation are the key points for the high successful rate.Conclusions： Within the limits of this clinical study,the results indicate that implant-supported full dentures can achieve satisfactory clinical results for severe periodontitis patients.