种植义齿个性化修复基台与成品修复基台在磨牙区的应用对比研究

A comparative study on the application of custom restoration abutment and stock restoration abutment of implant denture

目的:探讨和比较个性化修复基台及成品修复基台与修复体之间固位力的差异以及两者的临床应用效果。方法:修复基台与修复体粘接固位力的检测:选择个性化基台和成品基台试件复合体各10个,于万能试验机上行拉伸实验,记录拉伸曲线出现初次下降的峰值,为该试件的最大粘接固位力值。临床效果观察:选择单颗磨牙缺失拟种植修复的患者64例共64颗种植体,随机分为个性化基台组和成品基台组(32颗/组),以机械并发症、龈乳头指数、食物嵌塞情况、粉色美学评分和患者满意度评价修复效果。结果:个性化基台组与修复体的粘接固位力高于成品基台组(P<0.05);修复体和修复基台的粘接固位力与修复基台的表面积成正相关(r=0.864)。冠修复1年后,两组均未出现基台松动,成品基台组牙冠崩瓷1例,牙冠脱落1例,两组比较无显著差异(P>0.05);个性化基台组的龈乳头形态良好(PIS2级和PIS3级)比例、粉色美学评分、患者满意度均显著高于成品基台组(P<0.05),食物嵌塞率显著低于成品基台组(P<0.05)。结论:与成品修复基台相比,个性化修复基台与修复体的粘接固位力较高,在磨牙区种植修复中形成的龈乳头形态良好、食物嵌塞率低、美学效果佳,有良好的临床应用前景。

Objective:To explore and compare the difference of retentive force between the custom restoration abutment and the stock restoration abutment and their clinical application performance.Methods:The detection of the adhesive retention force between the restoration abutment and the restoration body:10 custom abutment and 10 stock abutment composites were selected,and pull-test was carried out on the universal testing machine,and the peak value of the first decrease in the tensile curve was recorded,which was the maximum adhesive retention value of the specimen.Observation of clinical effect:64 implants in 64 patients with single molar implant were randomly divided into custom abutment group and stock abutment group(32 implants per group).The restoration effect was evaluated by mechanical complications,gingival papilla index,food impaction,pink aesthetic score and satisfaction of patients.Results:The adhesive retention between the custom abutment group and restoration was higher than that between the stock abutment group(P<0.05),and the adhesive retentive force between the restoration and the abutment was positively correlated with the surface area of the abutment(r=0.864).One year after crown restoration,no abutment loosening occurred in either group,there were 1 case of porcelain collapse and 1 case of crown loss in the stock abutment group,there was no significant difference in porcelain collapse and crown loss between the two groups(P>0.05).The proportion of good gingival papilla shape(PIS2 and PIS3),pink aesthetic score and patient satisfaction in the custom abutment group were significantly higher than those in the stock abutment group(P<0.05),the food impaction rate was significantly lower than that in the stock abutment group(P<0.05).Conclusion:Compared with the stock restoration abutment,the adhesive retention between the custom restoration abutment and the restoration is higher,and the gingival papilla formed in the implant restoration of the molar area has a good shape,low food impaction rate and good aesthetic effect,and has a good prospect of clinical application.