保留末端基牙在无牙颌精确种植中的应用

Clinical Application of the Terminal Abument in Edentulous Implantation

目的:探讨保留末端基牙制作牙-黏膜支持式导板在无牙颌精确种植中的应用,并与无牙颌黏膜支持式导板的精准性进行比较。方法:选择临床上无牙颌种植患者18例共98颗种植体,分成两组。牙-黏膜组利用末端基牙制作牙-黏膜支持式数字化种植导板进行无牙颌种植体植入;黏膜组没有可利用的末端基牙,常规制作数字化黏膜支持式导板植入种植体。记录种植留存率及患者满意度。比较两组种植体植入前后位置差异测量值。所有患者术后随访6~20个月。结果:种植体的总存留率为98.97%,患者满意度较高。牙-黏膜组种植体植入颈部距离、尖端距离、植入深度、植入角度偏差均显著小于黏膜组(P<0.05)。结论:选择可以保留的末端基牙制作牙-黏膜支持式导板可以提高无牙颌种植的精准性及临床操作便利性,易于实现即刻修复,术者及患者的满意度比较高。这种治疗方案值得在全口种植即刻修复中推广。

Objective To explore the accuracy of dental-mucosal supporting guide plate made by retaining end abutment teeth and comparing with dental-mucosal supporting guide plate made by edentulous jaw.Methods 18 patients with edentulous jaw implants were selected and 104 implants were divided into two groups.The teeth-mucosa group used the end abutment to make dental-mucosa supported digital implant guides for edentulous jaw implants.The mucosa group did not have the end abutment which could be used,and the digital mucosa supported guides were made routinely.The retention rate of implants and patient satisfaction were recorded.The position differences between the two groups before and after implantation were compared.All patients were followed up for 6 to 20 months.Results The total retention rate of implants was 100%.Patient satisfaction is higher.The implant neck distance,tip distance,implant depth and implant angle deviation in dental-mucosal group were significantly smaller than those in mucosal group(P<0.05).Conclusion Selecting the retainable end abutments to make dental-mucosal supporting guide plate can improve the accuracy and clinical convenience of dental implantation,and it is easy to achieve immediate restoration.The satisfaction of the surgeons and patients is relatively high.Such treatment is worth promoting in immediate prosthetic implantation.