粘接固位与螺栓固位上部结构种植义齿修复前牙缺失临床疗效对照研究

Comparison of clinical effect between cemented and screw-retained restorations for implant-borne superstructures in anterior teeth

目的比较粘接固位与螺栓固位种植义齿上部结构修复前牙缺失的临床疗效。方法选取1997年7月至2006年7月中国医科大学口腔医学院种植中心因上、下前牙缺失而接受种植固位修复的147例患者,植入种植体210颗,包括BLB系统、ITI系统、Lifecore系统、JIAD系统。种植手术后6个月的骨整合期内,有2例患者的2颗种植体因骨结合不良早期脱落。其余145例患者的208颗种植体完成上部结构修复,其中使用螺栓固位基台130颗,使用粘接固位基台78颗。进行单冠修复132颗,联冠修复64颗,种植固定桥12颗。结果210颗种植体中,共脱落8颗,占3.8%。完成上部结构修复后的145例患者中,有78例患者有复查记录,随访复查比例为53.8%。130颗螺栓固位种植体中,有3例患者4颗种植牙患种植体周围炎;6例患者的8颗种植牙发生中央螺栓松动、基台暴露或崩瓷现象,其中有5例7颗接受螺栓固位基台的患者不满意,后经更换为粘接固位基台,重新制作牙冠后患者表示满意。使用螺栓固位基台的患者满意率为94.6%。使用粘接固位基台的78颗种植体中,有2颗种植牙烤瓷冠崩瓷,重新更换粘接固位基台并制作牙冠后,患者满意,粘接固位基台的满意率为100%。结论粘接固位上部结构修复前牙缺失的临床效果优于螺栓固位种植义齿。

Objective To compare the clinical effect between cemented and screw-retained restorations for implant-brone superstructures in anterior teeth.MethodsA total of 147 patients were treated for anterior teeth implantation from July 1997 to July 2006 in the department of Implant Center,School of Stomatology,China Medical University.A total of 210 endosseous implants were consecutively placed,including BLB,ITI,Lifecore and JIAD systems.Two implants in 2 patients were lost during the first 6-month integration after implantation.The superstructures of 208 implants were fixed after integration.Totally 130 implants were connected with screwed abutments,and the others were fixed with cemented abutments.The final prostheses included 132 single crowns,64 united-crowns and 12 bridges.ResultsTotally 8 in 210 implants were lost during 10 years,the failure ratio being 3.8%.Among the 145 patients who finished the final prostheses,78 patients were followed up,and the recheck rate was 53.8%.Among the 130 screw-retained implants,peri-implantitis was observed in 4 implants of 3 cases;7 implants in 5 cases were not satisfied with their crowns because of screw loosing or abutment exposing,and were replaced with cemented abutments.The satisfaction rate was 94.6% in screw-retained prosthesis.Among 78 cemented prostheses,ceramic crack was observed in 2 implants.The patients were satisfied after replacing the cemented abutments and fixing new crowns.The satisfaction rate was as high as 100% in cemented prosthesis.ConclusionThe clinical result of cemented prosthesis is better than screw-retained prosthesis when used for implant-borne superstructure in anterior teeth.