改良方法制作过渡义齿在牙种植美学修复软组织成形中的临床应用

Application of an Improved Method for Provisional Restoration Fabricating on Soft Tissue Contouring around Dental Implants

目的 :探讨一种改良方法制作过渡义齿,在牙种植美学修复中对软组织诱导成形的应用价值。方法 :采用改良方法制作过渡义齿,对22例前牙区单牙缺失及8例连续多颗牙缺失种植修复患者的44颗种植体周围软组织,进行诱导成形,种植一期手术时在种植模板引导下植入种植体后,利用模板将种植体三维位置及方向转移到模型上,在模型上制作过渡义齿,二期手术时直接安放过渡义齿对软组织进行诱导成形。另采用常规的愈合基台与过渡义齿两步诱导法对10例单颗前牙种植体周围软组织进行诱导作对照。结果:单牙缺失种植修复者,两组红色美学指数(PES)得分别为7.1±1.2与6.6±1.8(P<0.05)。改良方法制作过渡义齿组诱导时间为(2.8±1.8)个月,平均复诊次数(2.2±1.8)次;常规两步方法平均诱导时间为(9.5±2.5)个月,复诊次数为(4.6±2.7)次,诱导时间差异P<0.01,复诊次数差异P<0.05,差异均有统计学意义。连续多颗牙缺失种植修复者的软组织成型后也获得了较为美观的效果,诱导时间为2~6个月,复诊次数为2~5次。结论 :该改良方法制作过渡义齿用于种植美学修复中软组织的诱导,是一个可行且有效的软组织成型方法。

Objective： To evaluate the application value of a improved method for provisional restoration fabricating on soft tissue contouring. Methods： The peri-implant soft tissues around 22 implants of 22 patients, who received dental implantation in the aesthetic region, were contoured by improved contouring method. At the first stage surgery, the surgical templates were used to guide the implant placement and transfer the implant position to the dental casts, and the provisional crowns were fabricated on the casts. At the second stage surgery, the implant-supported provisional crowns were used instead of healing abutment to contour the soft tissues around the implants. In contrast, peri-implant soft tissues around 10 implants of 10 patients were contoured by conventional provisional crowns after soft tissue contouring with healing abutment for control. In addition, soft tissues around the 22 implants of 8 another patients, who received multiple unit implantation （2-4 implants） were contoured by improved method. Results： The PES of the soft tissue contoured by improved contouring method was higher than by conventional contouring method （P〈0.05）. Both the average contouring time and follow-up times in improved contouring group were lesser than that in conventional contouring group （P〈0.01, P〈0.05）. The aesthetic effects were also successed in patients, who received multiple implantation. Conclusion： Improved contouring method is a practicable and relatively ideal method for contouring peri-implant soft tissues.