CAD/CAM树脂桥联合数字化导板在无牙颌即刻负荷中的应用研究

Application of CAD/CAM resin bridge and digital surgical guide on immediate loading implant restoration of edentulous jaw

目的:研究和评估CAD/CAM树脂桥联合数字化导板在无牙颌患者即刻负荷中的应用效果。方法:选择30例无牙颌患者,共356枚植体,662颗冠,其中单颌9例,全口21例;均应用导板辅助外科植入,CAD/CAM树脂桥进行即刻负荷,在戴入后即刻、1个月、3个月进行效果评估,并统计种植体周围黏膜炎发生率、树脂桥的折裂率以及植入时和永久修复前的植体动度(ISQ)。结果:评估期间30例患者均无植体脱落现象。1个月和3个月的黏膜炎发生率分别为2.8%和3.3%,且集中在1例患者中;树脂桥的折裂情况在1个月时无发生,3个月时发生率1.5%,且集中在2例患者中。上颌植体植入时和永久修复前的平均ISQ值分别为62.70±1.07和81.81±1.52,下颌植体植入时和永久修复前的平均ISQ值分别为67.65±0.96和83.71±0.90,差异有统计学意义(P<0.0001)。结论:CAD/CAM树脂桥联合数字化导板,是一种可重复性高、临床效果好的无牙颌即刻负荷的临床诊疗新方法,值得推广和应用。

Objective： To investigate the clinical outcome of CAD/CAM resin bridge and digital surgical guide in immediate loading implant restoration of edentulous jaw. Method： 30 patients of edentulous jaw with 356 implants and 662 crowns were recruited, and immediate loading implant restoration with CAD/CAM resin bridge were used after the implanting operation with the digital surgical guide. The rate of peri-implant mucositis, the resin denture fracture, and the implant survival at the time point of implanting day, 1 month and 3months after the loading were recorded. The implant stability quotient（ISQ） value was also measured. Results： There was no implant loose or lost. The incidence of the peri-implant mucositis was 2.8% in 1 month, and it increased to 3.3% in 3 months due to failure on one patient. There was no resin bridge fracture in 1 month, and 1.5% of resin bridge fracture in 3 months on two patients. The mean ISQ values of maxillary implants after implantation and 3 months were 62.70±1.07 and 81.81±1.52. For the mandible implants, the corresponding values were67.65±0.96 and 83.71±0.90. There was statistically significant differences between two groups（P〈0.001）. Conclusion：Application of CAD/CAM resin bridge and digital surgical guide on immediate loading implant restoration of edentulous jaw shows a clinically optimal new method and is recommended.