3D打印个性化根形钛合金种植体在下颌磨牙区即刻种植的临床研究

Clinical Study on Immediate Implantation of 3D Printing Titanium Alloy Root Analogue Implant in Mandibular Molar Area

目的:初步评价3D打印个性化根形钛合金种植体在下颌磨牙区即刻种植的临床效果。方法:12例下颌磨牙拔除的患者,拍摄锥形束CT,设计表面多孔个性化根形种植体(Root Analogue Implants,RAI)并使用钛合金粉进行3D打印。术中采用微创拔牙,拔牙后,立即将RAI植入牙槽窝。所有患者术后3月、6月、12月复查,观察是否出现种植体松动、疼痛等并发症;术后3月行全瓷冠修复,术后3月、6月、12月评估其临床和影像学效果。结果:12例患者手术均成功,术后种植体无松动,无疼痛或敏感、无化脓性渗出,种植体周围软组织均表现出良好的边缘密合性,无明显附着丧失,所有患者术后3个月进行全瓷冠修复,在1年的观察期内种植体成功率为100%,功能性负载后种植体颈部骨水平无变化,种植体根部无透射影。结论:3D打印个性化根形钛合金种植体在下颌磨牙区即刻种植中具有良好的临床效果,可以作为磨牙即刻缺失种植修复的选择之一,但是需要对种植体的成功率和生存率进行长期评价。

Objective:To evaluate the clinical effect of 3D printing personalized root titanium alloy implant in mandibular molar area.Methods:Twelve patients with mandibular molar extraction were selected.The cone beam CT was used to design the surface porous root analogue implant(RAI)and 3D printing using titanium alloy powder.After minimally invasive tooth extraction,RAI was immediately implanted into the alveolar socket.All patients were reexamined for complications such as implant loosening and pain at 3,6,and 12 months after operation.All-ceramic crowns were restored after 3 months,and the clinical and imaging effects were evaluated at 3,6,and 12 months after operation.Results:All 12 patients were operated successfully.There was no loosening,no pain or sensitivity,and no suppurative exudation after operation.The soft tissue around the implant showed good marginal adhesion,and there was no obvious loss of attachment.All patients were restored with all-ceramic crown at 3 months after operation.The success rate of the implant was 100%during the 1-year observation period.After functional loading,there was no significant change in the bone level of the neck of the implant and no transmission image of the root of the implant.Conclusion:3D printing titanium root analogue alloy implant has a good clinical effect in the immediate implantation of the mandibular molar area,which can be used as one of the options for the immediate restoration of the missing molar.However,the long-term evaluation of the success rate and survival rate of the implant is needed.