后牙种植单冠修复中数字化和硅橡胶印模技术的临床应用比较

Clinical applicational comparison of digital impression and silicon rubber impression technique in posterior implant-supported single crown restoration

目的评估采用数字化印模技术和硅橡胶印模技术对牙列缺损患者行后牙种植单冠修复的临床效果及满意度,以期为临床提供参考。方法选取2018年3月至2021年1月于中山大学光华口腔医学院·附属口腔医院修复科就诊的64例牙列缺损患者,男性31例,女性33例,年龄(49.3±13.3)岁;植入113枚种植体,根据取模方式不同分为数字化印模组(70枚)和硅橡胶印模组(43枚),上部修复体均为螺丝固位的氧化锆全瓷单冠;修复完成后随访观察3~36个月,分析种植体存留率、上部修复体、种植体周围软组织和边缘骨吸收情况,并对患者进行满意度调查以评价两种印模技术用于后牙种植单冠修复的临床效果。结果64例患者中数字化印模和硅橡胶印模占比分别为62%(40/64)和38%(24/64),113枚种植体存留率为100%(113/113);种植单冠邻接丧失率为22.7%(41/181),食物嵌塞发生率为8.0%(9/113),机械并发症发生率为2.7%(3/113),均为基台螺丝松动;患者均可保持较好的口腔卫生,植体周炎发生率为0.9%(1/113),植体周黏膜炎发生率为4.4%(5/113);种植体边缘骨吸收为(0.24±0.11)mm;患者各项满意度视觉模拟评分中位数为9~10分;以上各项两组差异均无统计学意义(P>0.05)。结论采用两种印模技术行后牙种植单冠修复的短期临床效果均较好,患者主观满意度均较高,长期临床效果有待进一步观察。

Objective To investigate the clinical effect and satisfaction of partially edentulous patients restored with posterior implant-supported single crown by digital impression technique and traditional silicon rubber impression,in order to provide clinical reference.Methods Sixty-four partially edentulous patients who visited the Department of Prosthodontics,Guanghua School of Stomatology,Hospital of Stomatology,Sun Yat-sen University between March 2018 and January 2021 were enrolled.There were 31 male and 33 female,and the age of the group of patients was(49.3±13.3)years.The 113 implants placed in this group of patients were divided into digital impression group(n=70)and silicone rubber impression group(n=43)according to different impression techniques,and were restored with screw-retained full zirconia single crown,and the patients were followed up for 3-36 months after treatment.The implant survival rate,upper prosthesis,peri-implant soft tissue status,marginal bone loss and patients satisfaction were recorded to evaluate the clinical effects of two impression techniques in posterior implant-supported single crown.Results In sixty-four patients,digital impression accounted for 62%(40/64),and silicon rubber impression accounted for 38%(24/64),the survival rate of 113 implants was 100%(113/113).The prevalence of interproximal contact loss,food impaction and mechanical complication of the upper full zirconia single crown restorations were 22.7%(41/181),8.0%(9/113)and 2.7%(3/113)separately.All the mechanical complications were abutment screw loosening.All patients maintained good oral hygiene status,the incidences of peri-implantitis and peri-implant mucositis were 0.9%(1/113)and 4.4%(5/113)respectively.The marginal bone loss was(0.24±0.11)mm.The median of satisfaction visual analogue scale score in patients was 9-10,but no statistically significant differences of all the above results were observed between the two impression techniques(P>0.05).Conclusions The clinical effect of partially edentulous patients restored with posterior implant-supported single crown using two different impression techniques is good and the satisfaction of patients is high,but the long-term clinical effect remains to be further observed.