上颌前牙区后期种植与义齿即刻修复技术的联合应用研究

Union Using CDIC one-part modifiable abutment implant in late implantation and immediate restoration for anterior maxillary partially edentulous

目的 :在保障植入种植体实现骨性结合的前提条件下 ,达到既能减少手术创伤和缩短种植手术与义齿修复治疗的间隔时间 ,又能获得最佳的生理功能和美学效果。方法:按照CDIC后期种植手术与义齿即刻修复同期联合实施原则 ,选择CDIC纯钛锥状牙种植体系统中单件式可调磨基桩牙种植体 ,在局部浸润麻醉下直接钻微细小孔、旋转膨胀器扩大牙槽骨和挤压植放种植体 ;测试植入扭矩力后,即按前牙全冠修复固位体常规制备原则 ,口内直接修磨种植体上部基桩 ,同日佩带暂时塑胶牙冠或空缺 ,一周后更换烤瓷熔附金属全冠 ,完成种植义齿修复。结果:作者已完成127例 (男性69例 ,女性58例 ,最小年龄17岁 ,最大年龄76岁 )上颌前牙及双尖牙区个别牙缺失后的后期种植术 ,使用种植体243枚 ,植入扭矩力均值达到7.5kgf.cm ,种植体即刻稳固性良好 ;术后义齿即刻修复 ,其中单冠修复38枚 ,连冠修复122枚 ,种植体与自体牙联合修复85枚 ,随访观察期三年 ,成功率97.5 %。结论:针对上颌前部缺损牙列实施后期种植与义齿即刻修复技术时 ,CDIC纯钛单件式可调磨基桩种植体是目前最理想的种植体系统之一 ,既拓宽了临床应用范围 ,操作技术简便 ,又显现了满意的修复效果和极高的成功率 ,建议推广应用。

Objective:Anewmanneris used forthe anteriormaxilla partiallyedentulous patients,whichare late implan-tationbymeans ofthe CDICone-partimplantandimmediate restorationsimultaneously.Method:The pure titani-um implants,including the large diameter abutment、narrowneck and tapping screwroot with surface roughness profile,were designed by China Dental Implantology Center.The local condition of the replacement should be missing teeth over four-six months;the shape and thickness of the bony alveolar process is more than3.5mm;the height of the alveolar ridge is measured on panoramic radiograph,above15mm;Especially,these cases with poor bone quality and show unwillingness to accept any replaced bone or other materials.Surgical proce-dure with the implant,one-stage flapless、mini-pilot-drill hole and screwreplace to provide initial stabiliza-tion of the implant.After then,measure the primary stability and must be anchored into the bone at least the mean of7.5kgf·cm using the special torque wrench.Fixed prosthetic restoration procedure,preparation abut-ment,adjust angle and impression;the metal-ceramic crowns can be permanently cemented during the one-week.Results:In this report,there are127patients(69males and58females)aged17to76years,a total of243CDIC implants were placed into the anterior maxilla and immediate restoration.The follow-up period var-ied between12and36months,with a mean of24months.Osseo-integration was determined by clinical stabili-ty,lack of peri-implant pathology based on radiographic examination,the implant survival rate wax97.5%.Conclusion:The advantages of this technique are summarized as follow:widely indications minimal surgical trauma,simple procedure,and shorttime oftreatment.These are possibilities to accomplishprosthetic rehabilita-tions both aesthetically and functionally for patients