即刻负载的下颌套筒冠种植义齿在重度牙周病患者中的应用研究

Retrospective study of immediate loading with implant-supported mandibular telescopic overdenture in patients suffering from severe periodontal disease

目的介绍即刻负载的下颌套筒冠种植义齿在重度牙周炎患者中的应用,并评价其临床疗效。方法选择22位重度牙周炎患者,下颌颏孔区之间共植入88枚Ankylos种植体,采用Syncone套筒冠基台进行即刻修复、即刻负载,3个月后用纯钛支架义齿进行永久修复。修复完成后随访12~27个月,观察种植体周围软硬组织状况,计算存留率和成功率,调查患者满意度。结果 12~27个月观察期内,88枚种植体无脱落,存留率100%;仅有2枚边缘骨吸收大于2 mm,成功率达到97.73%;软组织状况均明显好转,牙周袋深度减小,探诊出血百分比降低,具有统计学差异;90.9%的患者都认为套筒冠义齿固位力足够,81.8%的患者认为使用12~27个月后,固位力无明显下降,95.46%的患者对这种义齿感到＂比较满意＂或者＂非常满意＂。结论即刻负载的下颌套筒冠种植义齿具有很高的存活率、成功率和患者满意度,有利于促进牙周病患者的软硬组织健康。

Objective To introduce a kind of implant-supported mandibular telescopic overdenture in patients suffering from severe periodontal disease and to evaluate its efficacy. Methods 22 patients with severe periodontal disease were included in this study. 4 Ankylos implants were placed between the mental foramen of each patient. Prefabricated Syncone telescopic abutments were connected to the implants and immediate denture was relined with prefabricated golden coping. After 3 months, definitive denture was made with titanium framework. After 12-27 months, the survival rate, the success rate as well as the soft and hard tissues around each implant were evaluated. The satisfactory level of each patient was also assessed by means of questionnaire. Results In the period of 12-27 months, the survival rate was 100%, and success rate was 97.73%. The condition of perio-implant soft and hard tissues improved. PD （probing depth） and BOP% （bleeding on probing % ） decreased with statistical differences. In the point of view of patient satisfaction level, 90.9% patients felt happy for the retention, and 81.8% felt no decrease in retention after 12-27 months. 95.46% patients felt satisfactory with their overdentures. Conclusion This treatment protocol has high survival rate, success rate and patients satisfactory level, which is helpful to improve the condition of soft and hard tissues around implants in patients suffering from severe periodontal disease.