不同方式制作后牙种植单冠临床效果观察

Clinical observation on the single crown of posterior teeth implantation by different methods

目的:比较椅旁数字化系统和传统硅橡胶印模技术不同方式制作的后牙全瓷冠在种植修复中的临床效果。方法:纳入单个后牙缺失种植修复患者135例,冠修复时随机分为3组(n=45),分别用传统硅橡胶印模技术制作二氧化锆全瓷冠(A组);椅旁数字化设备制作二硅酸锂全瓷冠(B组);椅旁数字化设备制作二氧化锆全锆冠(C组)。随访1年,用改良USPHS标准和患者满意度调进行评价。结果:牙周评价和修复体形态:3组间无统计学差异(P>0.05);修复体颜色、修复体邻接、咬合关系:B组和A组间无统计学差异(P>0.05),C组和A组间有统计学差异(P<0.05)。在取模感受和治疗舒适度方面B和C组患者的满意度高于A组(P<0.05);在修复效果上C组的满意度低于A、B组(P<0.05)。结论:采用椅旁数字化技术完成的二硅酸锂全瓷种植修复体形态、色泽、咬合和邻接等方面都符合临床应用要求,患者更舒适,满意度更高。

Objective:To compare the clinical effects of all ceramic crowns made by digital chair side system and traditional silicone rubber impression technology in implant-supported restorations.Methods:135 patients with single posterior tooth loss and treated with implant-support restoration were randomly assigned to 3 groups(n=45).In group A(control group)the patients were treated with all porcelain crown of zirconia made by traditional silicon rubber impression technology;in group B with all porcelain crown of lithium disilicate made by chairside CAD/CAM digital techniques;in group C with all porcelain crown of Zirconium dioxide made by chairside CAD/CAM digital techniques.The patients were followed up for 1 year,the effects were evaluated with improved USPHS standard and patient satisfaction survey.Results:There was no significant difference among group A,B and C(P>0.05)in the evaluation of restoration morphology and periodontal indexes.There was no significant difference between group B and group A(P<0.05)for the color,teeth adjacency and occlusal relationship,but there was significant differences between group C and group A(P<0.05).Satisfaction survey showed that the experience of digital scanning(group B and C)was better than that of traditional impression(group A)(P<0.05),and the comfort level of treatment of group B and C were also higher than that of group A(P<0.05).In terms of repair effect,the satisfaction of group C was lower than that of group A and B(P<0.05).Conclusion:The lithium disilate all-porcelain implant prosthesis made by the chairside digital technology not only meets the requirements of clinical application in terms of shape,color,occlusion and teeth adjacency,but also provides more comfortable experience and higher satisfaction for patients.