口腔种植个性化软组织印模的改良方法与应用评价

Modification and evaluation of a custom impression technique for soft tissue around dental implant

目的对口腔种植个性化软组织印模技术进行改良,比较传统法和改良法制作个性化转移杆的临床用时和耗材用量,评价改良法的临床适用性。方法2020年10月至12月,从北京大学口腔医院修复科收集20颗上颌前牙种植临时冠,采用自身对照的方法,分别按照传统法和改良法制作个性化转移杆。传统法使用油泥型硅橡胶制作阴模,复制临时冠颈部形态,再依此制作个性化转移杆。改良法首先制作通用型预成底座(可重复利用),结合流动性硅橡胶形成阴模,再制作个性化转移杆。记录并比较两种方法的临床用时和耗材用量。结果临床用时方面,改良法制作阴模的时间(323.6±20.3)s显著低于传统法(482.8±43.5)s,两者差异有统计学意义(P<0.05);改良法和传统法的个性化转移杆成型时间分别为(215.6±9.8)s和(213.4±10.9)s,两者差异无统计学意义(P>0.05)。耗材用量方面,改良法不需使用化学固化树脂,传统法的化学固化树脂用量为(427.5±72.2)mg;改良法的硅橡胶用量(524.5±29.1)mg显著低于传统法(14473.1±732.6)mg,两者差异有统计学意义(P<0.05);改良法和传统法的模型树脂用量分别为(82.0±17.4)mg和(80.0±13.4)mg,两者差异无统计学意义(P>0.05)。结论改良法制作口腔种植个性化转移杆的临床用时和耗材用量均少于传统法。采用改良法制取口腔种植个性化软组织印模,可节省椅旁操作时间、节约耗材用量、降低成本,值得在临床推广使用。

Objective The aim of this study was to modify the custom impression technique for soft tissue around a dental implant,to compare the clinical working time and material consumption for fabricating custom impression coping with conventional and modified methods,and to evaluate the clinical applicability of the modified method.Methods From October to December 2020,20 implant-supported interim restorations of the maxillary anterior teeth were collected in the Department of Prosthodontics,Peking University School and Hospital of Stomatology.The conventional and modified methods were used to fabricate custom impression coping by self-controlled trial.Within the conventional method,a silicone matrix was used to capture the emergence profile of the interim restoration,thereafter a custom impression coping was made accordingly.In the modified method,a prefabricated reusable resin base embedding an implant analog was made.The base and a flowable silicone were used to register the soft-tissue transition zone created by the interim restoration.Finally,the tissue contour was transferred to the impression post.The working time and material consumption of the two methods were recorded and compared.Results In terms of clinical time,the average time of fabricating the index by the modified method was(323.6±20.3)s,which was significantly lower than that of the conventional method(482.8±43.5)s The average time of making impression coping with the conventional and modified methods were(213.4±10.9)s and(215.6±9.8)s,respectively.There was no significant difference between the two groups(P>0.05).In terms of the material consumption,the improved method does not require the use of self-cure resin,while the average weight of the self-cure resin of the conventional methods were(427.5±72.2)mg.There was significant difference between the two groups(P<0.05).Regarding the consumption of the silicone matrix,the modified method was(524.5±29.1)mg,which was significantly lower than that of the conventional method(14473.1±732.6)mg.The difference between the two methods was significant.The average weight of pattern resin of the conventional and modified methods were(80.0±13.4)mg and(82.0±17.4)mg,respectively.The difference between the two groups was not significant(P>0.05).Conclusions The clinical working time and material consumption spent on fabricating the custom impression coping by the modified method were less than those of the conventional method.Therefore,the modified method of custom impression for soft tissue may save chairside time and materials.It is worthy of clinical application..