美学区种植不同即刻修复方式对临床疗效影响的初步研究

Preliminary Study on Different Immediate Restoration Methods on the Clinical Efficacy of Implantation in the Aesthetic Area

目的探究不同种植即刻修复方式对美学区单牙种植修复治疗疗效的影响。方法研究分析2014年8月—2016年8月于浙江大学医学院附属第一医院口腔医学中心行上颌美学区单牙种植修复并即刻修复的51例患者,其中采用Ti-base基台,CAD-CAM树脂临时冠修复患者27例(研究组),采用成品临时基台,同期制作临时树脂冠患者24例(对照组)。患者修复后随访时间均为18~42个月,分析比较两组患者临时修复期间及永久修复后的临床疗效。结果即刻修复后6个月,研究组种植体周围探诊深度(PD)与对照组无显著性差异(P>0.05),研究组改良龈沟出血指数(mBI)、菌斑指数(PLI)低于对照组,差异有统计学意义(P<0.05)。永久修复后1年,研究组种植体边缘骨吸收量与对照组无显著差异,研究组单牙红色美学评分(PES)略高于对照组,差异无统计学意义(P>0.05)。结论 Ti-base基台,CAD-CAM树脂临时冠种植修复短期内可减少种植体周菌斑积聚,减轻牙龈炎症,但不影响种植修复的长期疗效,两种临时修复方式均能达到良好的远期美学效果。

OBJECTIVE To investigate the clinical curative effect of two implant immediate restoration methods in the treatment of aesthetic area. METHODS It select 51 cases of patients with single-tooth implant in maxillary aesthetic area in target hospital between-August 2014 and August 2016. Among them, 27 patients in the study group were using Ti-base abutment and were restored with CAD-CAM resin temporary crown, and 24 patients in the control group were using made-up abutment and were restored with hand-made resin contemporary crown. All the patients had a follow-up of 18 to 42 months after the implant restoration. The clinical efficacy during the period of contemporary restoration and after permanent restoration of the patients in the two groups were analyzed and compared. RESULTS 6 months after contemporary restoration, modified sulcus probing depth in the study group had no significant difference compared to the control group（P〈0.05）, bleeding index and plaque index in the study group was significantly lower than the control group（P〈0.05）. 1 year after permanent restoration, theimplant marginal bone absorption in the study group had no significant difference compared to the control group, the single tooth pink esthetic score（PES） was slightly higher than that in the control group,but with no significant difference（P〈0.05）. CONCLUSION The use of Ti-base abutment and CAD-CAM resin contemporary crown can decrease the content of plaque accumulation and gingival inflammation in the short term, while it made no difference to the long-term theraputic effect of implant restoration. Both methods could provide good aesthetic effect in the long run.