种植义齿修复10年临床效果评价

A clinical evaluation of implant dentures over 10 years

目的:评价种植义齿的中、长期临床效果。方法:1995年6月至2005年6月,为1121例患者植入了1786颗种植体并完成上部结构修复,种植体系统分别为Br+nemark系统92颗、ITI系统108颗、Replace系统21颗、Lifecore系统79颗、BLB系统1486颗。其中,单牙螺丝固定修复510例,单牙粘结固定修复413例,固定桥修复175例,种植体支持的覆盖义齿23例。随访9～122个月,观察方法为X线片、临床观察、患者满意度调查。应用寿命表法计算10年累计存留率,应用SAS9.1.3软件对数据进行配对t检验。结果:1102例患者的1760颗种植体完成骨整合。19例患者的26颗种植体松动脱落,10年累计存留率为98.1%。510例烤瓷冠螺丝固定患者中,39例发生螺丝松动,2例折断;413例烤瓷冠粘结患者中,17例崩瓷,5例冠脱落。X线片比较检查种植体周围骨吸收状况,结果无显著性差异。患者对美观、发音满意度和固位、咀嚼能力在种植治疗后明显提高,并具有统计学差异。结论:种植义齿是修复缺失牙的有效方法,本组病例10年累计存留率为98.1%。

PURPOSE： To evaluate the medium and long term clinical results of implant dentures. METHODS： A total of 1786 implants were consecutively inserted in 1121 patients from June. 1995 to June. 2005, with superstructure completed. Among them, 92 were of Branemark implants, 108 ITI implants, 21 Replace implants, 79 Lifecore implants, and 1486 BLB implants. Among the patients, 510 were treated with single tooth screw-retained prostheses, 413 with single tooth cement-retained prostheses, 175 with fixed-bridge prostheses, and 23 with implant-supported overdentures. The overall results were evaluated by radiography, clinical examination and patient satisfaction investigation during follow- up periods varying from 9 to 122 months. 10-year cumulative survival rate was calculated by life-table analysis. The data were analyzed using paired-samples t test with SAS9.1.3 software package. RESULTS： 1760 implants gained osseointegration in 1102 patients, and 26 implants were lost in 19 patients, with a cumulative survival rate of implants being 98.1% over the 10 years. Among the 510 cases with screw-retained ceramic crowns, prosthesis loosening was observed in 39 cases and fracture in 2 cases; among the 413 cases with cement-retained crowns, ceramic crack was observed in 17 cases and crown disengagement in 5 cases. In comparison of bone absorption value in X-ray , there was no statistical difference among different implant systems. Patient satisfaction investigation showed a significant increase in aesthetics ,phonetics, mastication and retention after treatment. CONCLUSIONS： Implant denture is an effective method to restore lost teeth. The cumulative survival rate of implants is 98.1% for the series of cases.