个性化全瓷基台在前牙种植修复中的应用

Clinical application of personalized all-ceramic abutments in anterior implant aesthetic restorations

目的探讨个性化全瓷基台在前牙区种植修复的美学效果。方法临床上收集51例前牙缺失患者（共植入60枚种植体）作为研究对象,根据患者意愿,26例选择个性化金属纯钛基台纳入对照组即：个性化钛基台＋全瓷冠修复（30枚）;25例患者选择个性化全瓷基台纳入实验组即：个性化全瓷基台＋全瓷冠修复（30枚）。通过两组对照研究,术后1、6、12个月复诊,分别记录红白复合美学指数、牙龈指数及菌斑指数,将数据进行统计学分析。结果术后1、6个月红白美学指数差异无统计学意义;术后12个月比较：（1）红色美学指数：实验组（30例）高于对照组（28例）,差异有统计学意义（χ^2=6.696,P=0.020）;（2）白色美学指数：实验组（30例）高于于对照组（29例）,差异有统计学意义（χ^2=6.634,P=0.021）。术后1个月菌斑指数和牙龈指数差异无统计学意义;术后6个月两组比较菌斑指数（t=3.128,P=0.003）和牙龈指数（Z=-3.537,P=0.000）差异均有统计学意义;术后12个月两组比较菌斑指数（t=3.027,P=0.004）和牙龈指数（Z=-6.785,P=0.000）差异均有统计学意义。结论在前牙种植美容修复中,个性化全瓷基台较钛基台优势明显,值得临床推广。

Objective To evaluate the aesthetic effects of restorations with personalized all-ceramic abutment in the anterior teeth zone. Methods Fifty-one patients with 60 missing anterior teeth in maxilla were selected. According to the wishes of patients,personalized titanium abutment and all ceramic crowns were used to restore 30 teeth in 26 patients in the control group：personalized zirconia abutmentand all ceramic crowns were selected to restore 30 teeth in 25 patients in the experimental group. Clinicalevaluation was scored by pink aesthetic index,white aesthetic index,gingival index and gingival index at1,6,and 12 months after the restorations were placed. Statistical analysis was performed using SPSS 16.0software package. Results The pink aesthetic index and white aesthetic index were not significantlydifferent in 1 and 6 months after operation between two groups. Pink aesthetic index（χ^2= 6.696,P =0.020）was higher in the experimental group（n = 30） than the control group（n = 28）;white aestheticindex（χ^2=6.634,P=0.021）was higher in the experimental group（n=30）than the control group（n=29）in twelve months after operation. Plaque index and gingival index had no significant differences in 1 monthafter operation between two groups. Plaque index（t = 3.128,P = 0.003）and gingival index（Z =-3.537,P = 0.000）were significantly different in six months after operation. Plaque index（t = 3.027,P = 0.004）and gingival index（Z =-6.785,P = 0.000）had significant difference in twelve months after operation.Conclusion Personalized all-ceramic abutments can effectively improve the aesthetic appearance of theimplant denture in maxillary anterior zone.