磨牙缺失颌间距离不足种植体支持的螺丝固位一体冠修复临床分析

目的:观察磨牙缺失颌间距离不足种植体支持的螺丝固位一体冠修复体的临床效果.方法:选取376例磨牙缺失、颌间距离不足,不能满足常规种植修复5～7 mm的修复空间的患者,共计507颗种植体,采用常规种植一期手术,并运用种植体支持的螺丝固位一体冠修复.随访6个月～2 a,记录螺丝固位的一体冠修复体的临床效果,采用SPSS17.0软件包对数据进行方差分析和x2检验.结果:经过6个月～2 a的随访观察,种植体存留率为99.61％,37例患者发生崩瓷,主要发生在3～4 mm组.在各组别中,烤瓷修复比金属(牙合)面烤瓷更容易发生崩瓷(P＜0.05);颌间距离越小,越容易发生崩瓷(P＜0.05).13件修复体发生螺丝松动,13例患者出现牙龈红肿,探诊出血.经牙周治疗及口腔卫生宣教后恢复良好.患者满意度较高.结论:种植体支持的螺丝固位一体冠修复设计可以解决磨牙区颌间距离不足的缺牙患者的修复难题,治疗效果良好.

A clinical analysis of screw-retained implant-supported casted integrated abutment crowns in the molar region with limited interocclusal space

PURPOSE:To observe the clinical effects of screw-retained implant-supported casted abutment integrated crowns (IACs) in the molar region with limited interocclusal space.METHODS:This study involved 507 implants in 376 patients with limited interocclusal space in the molar region.All implants were inserted to the jaw by standard one-stage protocol.Screw-retained IACs were used as the final prosthesis.With 6 to 24 months follow-up,the clinical effects of screw-retained IACs were recorded and analyzed using SPSS 17.0 software package.RESULTS:During 6 to 24 months of follow-up,the implant survival rate was 99.61％.37 patients had ceramic fracture which mainly happened in the group with 3-4 mm interocclusal space.In each group,porcelain fused to metal (PFM) prosthesis had ceramic fracture more easily than PFM prosthesis without porcelain on occlusal surface (P＜0.05).As the interocclusal space became smaller,the probability of collapsing porcelain increased (P＜0.05).13 patients had screw loosening.13 patients suffered from gingival swelling and bleeding,they were given periodontal treatment and oral hygiene instruction.Patients were satisfied with the restoration results.CONCLUSIONS:Screw-retained IACs can be used to repair missing teeth in the molar region with limited interocclusal space.