应用超亲水种植体早期负重修复的临床研究

Clinical study on early loading restoration of superhydrophilic implants

目的研究应用一种超亲水种植体早期负重修复1年后的临床效果,为临床提供参考。方法纳入2017年7月至2019年1月就诊于杭州口腔医院(平海院区)VIP诊室的41例牙列缺损患者,男性20例,女性21例,年龄(52.3±13.1)岁,共植入74枚超亲水种植体,其中上颌27枚,下颌47枚。所有患者均无需行骨增量或软组织移植术,采用Thommen系统配套种植工具行常规种植,上颌于种植体植入后4周取模,6周负重,下颌于植入后2周取模,4周负重。种植体植入、取模和负重前均利用共振频率分析仪测量种植体稳定系数(implant stability quotient,ISQ)。取模即刻、负重即刻及负重1年后分别拍摄根尖X线片,测量并记录种植体近远中边缘骨水平的变化。结果所有种植体在负重修复前均未出现生物学并发症,种植体存留率为100%(74/74)。2例下颌位点的种植体在术后2周时ISQ值低于65,延期取模修复。其余72枚种植体在植入时的ISQ值(75.22±4.32)与取模时(75.13±4.23)差异无统计学意义(P>0.05);负重即刻ISQ值(76.46±3.73)显著大于取模时ISQ值(P<0.05)。72枚早期负重修复的种植体在负重后1年复查,均未发生松动脱落,种植体存留率为100%(72/72)。X线片测量评估显示,早期负重修复1年后72枚种植体近中边缘骨吸收为(0.18±0.06)mm,其中下颌[(0.17±0.06)mm]与上颌[(0.19±0.06)mm]差异无统计学意义(P>0.05);早期负重修复1年后72枚种植体远中边缘骨吸收为(0.17±0.05)mm,其中下颌[(0.17±0.06)mm]与上颌[(0.16±0.05)mm]差异无统计学意义(P>0.05)。结论在本临床研究有限的范围内,证实超亲水种植体早期负重是一种安全可行的治疗方案,长期负重后的种植体边缘骨吸收情况有待进一步观察。

Objective To study the clinical effect of early loading restoration a superhydrophilic implant after 1 year,so as to provide reference evidence for clinical practice.Methods A total of 41 patients with dental defects,including 20 males and 21 females[age(52.3±13.1)years old],were enrolled in the Department of VIP,Hangzhou Dental Hospital(Pinghai Hospital)from July 2017 to January 2019.A total of 74 superhydrophilic implants were implanted,including 27 maxillary implants and 47 mandiolar implants.All patients without bone augmentation or soft tissue transplantation,the maxilla was taken impression 4 weeks after implant implantation,with 6 weeks of loading,the mandible was taken impression 2 weeks after implant implantation,with 4 weeks of loading.The stability of the implant was measured by resonance frequency analyzer before implant implantation,impression and loading.Periapical radiograph were taken immediately after mold removal,immediately after loading and reexamination 1 year after loading,to measure and record the changes in the bone level of the mesial and distal margins of the implant.Results No biological complications occurred in all implants before loading restoration,and the implant survival rate was 100%(74/74).In 2 cases,the implant stability quotient(ISQ)value of the implant at the mandibular site was lower than 65 at 2 weeks after surgery,and the restoration was delayed.The ISQ values of the other 72 implants at the time of implantation(75.22±4.32)were not significantly different from those at the time of modeling(75.13±4.23)(P>0.05),but the ISQ values at the moment of weight loading(76.46±3.73)were significantly higher than those at modeling(P<0.05).All the early loading implants were reviewed 1 year after early loading,and none of them were loose or fell off,and the implant survival rate was 100%(72/72).X-ray measurement and evaluation showed that after 1 year of early loading restoration,the mean marginal bone absorption of 72 implants was(0.18±0.06)mm,among which the mandibular was(0.17±0.06)mm and the maxillary was(0.19±0.06)mm,showing no statistical difference(P>0.05).After 1 year of early loading restoration,the mean marginal bone absorption of 72 implants was(0.17±0.05)mm,including(0.17±0.06)mm for mandibular and(0.16±0.05)mm for maxillary,showing no statistical difference(P>0.05).Conclusions In the limited scope of this clinical study,it has been proved that early loading of superhydrophilic implant is a safe and feasible treatment scheme,and the bone resorption at the implant edge after long-term early loading restoration needs further follow-up study.