种植义齿冠根比与临床并发症

Research progress on the crown-implant ratio and clinical complications

天然牙的冠根比理论已经被口腔医学领域广泛认同,在预测判断天然牙的保留价值、义齿修复时基牙选择等方面有着重要的临床意义。过去几十年中,学者们根据天然牙的冠根比理论,提倡植入尽量长的种植体以提高成功率。然而随着短种植体的应用,种植理念发生了新的变化,种植义齿冠根比(crown-implant ratio,C/I)与并发症的关系成为了目前研究的热点之一。本文根据循证文献就C/I的概念、C/I与种植体存留率及种植修复临床并发症进行分析讨论和总结,并提出建议:虽然目前多数的研究表明C/I与种植体存留率及颈部边缘骨吸收无显著相关性,但可能会增加机械并发症的风险。建议临床种植修复时C/I值尽量小于3,冠长尽量小于15 mm;同时在使用短种植体及超短种植体时,选用增加骨-种植体接触面积的种植体系统,采用联冠或桥等夹板式修复方式。

The crown-root ratio(C/R)theory of natural teeth has been widely recognized in the field of stomatology,and has important clinical significance in predicting and assessing the prognosis of natural teeth as well as for abutment selection during denture restoration.In the past few decades,scholars have advocated for the implantation of implants as long in length as possible to improve the success rate according to the theory of crown-root ratio of natural teeth.However,with the application of short implants,our philosophy of implantation has changed,and the relationship between the crown-implant(C/I)ratio and complications has become one of the current research hotspots.In this paper,the con-cept of the crown-implant ratio,the research progress of the C/I ratio,the implant survival rate and clinical complica-tions of implant restoration were reviewed and summarized,and the following suggestions were put forward:although most studies have shown no significant correlation between the C/I ratio and implant survival or marginal bone loss,this relationship may increase the risk of mechanical complications.A C/I<3 and a crown length<15 mm are recommend-ed in implant restoration;when ultra-short implants are applied,the implant system can increase the bone-to-implant contact area,and splint prostheses such as crown or bridge are recommended.