上海口腔医学

上海口腔医学 ›› 2021, Vol. 30 ›› Issue (4): 384-388.doi: 10.19439/j.sjos.2021.04.009

• 论著 • 上一篇    下一篇

全氧化锆单牙种植体支持带角度螺钉通道基牙修复短期疗效评价

林后学1, 黄静1, 孙亚轩1, 夏金星2   

  1. 1.安徽省马鞍山十七冶医院 口腔科,安徽 马鞍山 243000;
    2.南京市第一医院 口腔科,江苏 南京 210006
  • 收稿日期:2020-11-06 修回日期:2021-01-12 出版日期:2021-08-25 发布日期:2021-09-23
  • 通讯作者: 林后学,E-mail:ab123aboo@126.com
  • 作者简介:林后学（1970-）,男,硕士,副主任医师
  • 基金资助:
    国家科技支撑计划资助项目（2005BAI16B05）

Full-zirconia single-tooth molar implant-supported restorations with angulated screw channel abutments: evaluation of short-term outcomes

LIN Hou-xue1, HUANG Jing1, SUN Ya-xuan1, XIA Jin-xing2   

  1. 1. Department of Stomatology, Anhui Ma'anshan 17th Metallurgical Hospital. Ma'anshan 243000, Anhui Province;
    2. Department of Stomatology, Nanjing First Hospital. Nanjing 210006, Jiangsu Province, China
  • Received:2020-11-06 Revised:2021-01-12 Online:2021-08-25 Published:2021-09-23

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摘要： 目的: 探讨全氧化锆单牙种植体支持带角度螺钉通道基牙的修复效果。方法: 前瞻性选择2016年3月—2018年3月接受上颌和下颌后牙区域单牙种植的牙缺失患者76例,均于种植后3个月提供带角度螺钉通道基台;分别于植入物放置即刻（T0）、4周（T1）、1年（T2）和2年（T3）进行随访,测量改良龈沟出血指数（mSBI）、改良菌斑指数（mPLI）、牙周探诊深度（PD）、种植体边缘骨水平（MBLs）和中颊黏膜水平（MBMLs）;记录随访期间种植体不良发生率、存留和崩瓷情况。采用SPSS 23.0软件包对数据进行统计学分析。结果: 76例患者中,9例无完整随访记录（2颗种植体在修复前失败,2例双侧第一磨牙缺失,5例失访）,67例患者共67颗植入物随访记录完整,1年随访时种植体成功率为97.01%（65/67）,3个月后再次随访确定成功,初期成功率为100%。与T0时相比,T1、T2、T3时mSBI、mPLI依次显著降低（P<0.05）;T0、T1、T2、T3时PD水平无显著差异（P>0.05）,有效深度平均为1.75 mm。与T0时相比,T1时MBLs、MBMLs显著增加（P<0.05）;之后T2、T3时MBLs、MBMLs变化较小,与T1相比无显著差异（P>0.05）。T1时较T0时近中和远端乳头的ISQ水平降低（P<0.05）;之后T2、T3时变化较小,与T1相比无显著差异（P>0.05）。T1时共出现4例种植体维护,包括确定种植体冠、饰面瓷和氧化锆基牙断裂及美学顾虑,T2、T3时刻无种植体修复问题,螺钉完好、无松动。共发生种植体周围炎2例、种植体松动1例、基牙疼痛1例,经积极治疗均得到显著改善。67个全氧化锆修复体2例出现崩瓷（2.63%）,种植体存留率为100%。结论: 全氧化锆单牙种植体支持带角度螺钉通道基牙修复显著提高了种植体初期稳定性,总成功率高,且远期疗效好、并发症少。

关键词: 全氧化锆, 单牙种植体, 带角度螺钉通道, 基牙修复

Abstract: PURPOSE: To evaluate the effect of full-zirconia single-tooth molar implant-supported restorations with angulated screw channel abutments. METHODS: Seventy-six patients with a single missing tooth in the posterior region of the maxilla and mandible underwent dental implants from March 2016 to March 2018 were enrolled. After 3 months, each patient received a full-contour screw-retained zirconia restoration with angulated screw channel abutment. Modified sulcus bleeding index (MSBI), modified plaque index (mPLI), periodontal probing depth (PD), marginal bone levels (MBLs) and mid-buccal mucosal levels (MBMLs) were recorded at the implantation moment (T0), four weeks (T1), one year (T2) and two years (T3) after treatment. During the follow-up period, the incidence of implant defects, survival rate and porcelain fracture were recorded. The data were processed using SPSS 23.0 software package. RESULTS: Of the 76 patients, 9 did not have a complete follow-up record (two of the implants failed before restoration, two patients had bilateral first molars missing, and five were lost to follow-up), and the remaining 67 patients with a total of 67 implants had a complete follow-up record. The success rate of implant was 97.01%(65/67) during one-year follow-up, and the initial success rate was 100% at an interval of three months. Compared with indexes at T0, mSBI and mPLI were significantly reduced at T1, T2 and T3 (P<0.05). There was no significant difference in PD level at T0, T1, T2 and T3(P>0.05), and the effective depth averaged 1.75 mm. Compared with indexes at T0, MBLs and MBMLs were significantly increased at T1(P<0.05). A total of 4 cases had implant reconstruction at T1 due to concerns about framework fracture, veneering fracture and aesthetics. At T2 and T3, there was no implant problems and loosening of restoration. There were 2 cases of peri-implant inflammation, one case of implant loss and one case of abutment pain, which were all improved after corresponding treatments. Two cases of porcelain fracture occurred in 67 zirconia restorations (2.63%), and the implant survival rate was 100%. CONCLUSIONS: Full-zirconia single-tooth molar implant-supported restorations with angulated screw channel abutments can effectively improve the implant stability in early phase, with high success rate, good short-term effect and few complications.

Key words: Full-zirconia, Single implant, Angulated screw channel, Abutment restoration

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