即刻负荷种植覆盖线性(牙合)全口义齿的临床初步应用

目的探讨线性胎用于2枚种植体支持的即刻负荷下颌种植覆盖全口义齿的临床可行性、技术特点并评估其临床效果。方法在6例下颌牙槽骨严重吸收的无牙颌患者的颏孔前区植入2枚种植体，术后即刻印模转移，24h内完成杆卡式附着体固位的覆盖线性胎全口义齿修复。于术后1周，负荷后1、3、6、12个月复诊，之后每6个月复诊1次，检查种植体的稳定性、种植体周牙龈组织的健康状况，拍摄曲面断层X线片观察种植体周骨高度变化，检查修复体戴用情况，评估患者满意度。结果6例患者共植入12枚种植体，追踪观察9～30个月，种植体均无松动或脱落。种植体周牙龈出血指数为0～1、龈沟深度均小于2mm，牙龈组织健康。曲面断层X线片显示，即刻负荷后第1年种植体周骨吸收量均在1mm以内，未见明显骨吸收。患者对修复效果满意。结论在下颌牙槽骨严重吸收的无牙颌患者的颏孔前区植入2枚种植体，即刻采用杆卡式附着体固位的种植覆盖线性眙全口义齿修复是可行的，近期临床效果满意，长期效果需进一步观察。

Primary clinical application of linear occlusion in immediate loading and implant-supported mandibular overdenture

OBJECTIVE: To investigate clinical feasibility and technical features of immediate loading with linear occlusion on 2-implant-supported overdenture and to evaluate short-term effect of the treatment METHODS: Six edentulous patients with severe residual ridge resorption were enrolled. Two interforaminal implants were inserted for each patient and then immediate impressions were taken. Implant-supported bar-retained overdentures were restored for the patients within 24 hours. Clinical and radiographic examinations were conducted post-operative 1 week and 1, 3, 6, and 12 months. Thereafter at every 6 months the stability of implants, tissue situations around implants, radiographs and satisfaction level of patients were examined for each patient. RESULTS: Six cases and 12 implants were followed from 9 to 30 months. No implant was loosened or dropped. Sulculus bleeding index was 0-1 and probing depth of sulcus was less than 2 mm. The gingival tissues around the implants were healthy. Radiographic examination showed that bone resorption was less than 1 mm in the first year. The alveolar bone around the implants hasn't show obvious resorption stable height. Patients were satisfied with the implants. CONCLUSIONS: The results of this study indicate that immediate loading using linear occlusion on implant-supported bar-retained overdenture is predicable in some cases and can achieve satisfaction in the short-term service. Further study is needed to assess the long-term results.