无牙颌固定种植修复设计的研究进展

Research progress in the design of implant-supported fixed full-arch prosthesis

长期以来,作为口腔修复领域的重点与难点,牙列缺失后的重建问题备受关注。随着社会生活水平的提高,人们对全口义齿提出了更高的要求,固定种植修复因其舒适、美观和极佳的性能,越来越受到临床医生与患者的青睐。固定修复体与种植体刚性连接并完全由其支持,患者无需取下,固位和稳定性能最好,咀嚼效能接近天然牙列。特别是即刻负载模式的推广,许多患者在种植术后短期内就能获得一副功能良好的固定修复体,很大程度上缩短了患者的等待时间。然而,由于修复体跨度长,种植体数目多,力学结构复杂,加之不同患者的解剖情况各异,无牙颌固定种植修复的设计也最为考究。选择种植修复方案时,种植体数目、分布形式、负载模式,以及上部结构的设计等都与最终修复效果息息相关。随着研究的不断深入,近十余年来,种植修复的方案设计和理念有了很大改变。本文就固定种植修复不同设计方案的最新研究进展进行探讨,希望能为临床医师在修复无牙颌时提供一定的参考。

For a long time,as a key point and difficulty in the field of oral Prosthodontics,the reconstruction of edentulous jaw have attracted much attention.With the improvement of the social living standard,people put forward higher requirements for the complete denture.The implant-supported fixed full-arch prosthesis has been more and more favored by clinicians and patients because of its comfort,beauty,and excellent performance.The fixed prosthesis is rigidly connected to and fully supported by the implant,and the patient does not need to remove it.This treatment has the best retention and stability,and the masticatory efficacy is close to that of natural dentition.Especially with the promotion of immediate loading protocol,many patients can receive a well-functioning fixed prosthesis within a short period after implantation,which greatly reduces the waiting time.However,due to the long span of the prosthesis,the number of implants,the complex mechanical structure,as well as the different anatomical conditions of different patients,the design of fixed full-arch prosthesis is also the most elaborate.The implant numbers,distribution,loading protocols,and superstructure designs are all closely related to the final effect when determining the surgical and prosthetic procedures of edentulous jaws.With the deepening of research,the design and views of implant prosthesis have changed greatly in the past decade.In this paper,the latest research progress of fixed full-arch prosthesis is reviewed to provide references for clinicians in the treatment of edentulous jaws.