目的:对比高嵌体与全冠在修复牙体缺损中的美学效果及预后。方法:选取2020年6月-2022年1月笔者医院收治的牙体缺损患者120例(共229颗患牙),采用随机数字法分为对照组(60例,113颗患牙)和观察组(60例,116颗患牙),对照组采用常规全瓷冠修...目的:对比高嵌体与全冠在修复牙体缺损中的美学效果及预后。方法:选取2020年6月-2022年1月笔者医院收治的牙体缺损患者120例(共229颗患牙),采用随机数字法分为对照组(60例,113颗患牙)和观察组(60例,116颗患牙),对照组采用常规全瓷冠修复治疗,观察组采用CAD/CAM全瓷高嵌体修复治疗,观察两组的修复时间(备牙时间、取模时间和总体操作时间),治疗后第6个月、12个月及18个月的修复效果,以及治疗前、治疗后第3个月牙周指标及龈沟液生化指标[C反应蛋白(C-reactive protein,CRP)、人CXC趋化因子配体16(CXC chemokine ligand 16,CXCL16)、白细胞介素1β(Interleukin-1β,IL-1β)]变化,对比两组牙齿美观满意度。结果:观察组备牙时间、取模时间和总体操作时间均显著低于对照组(P<0.05);观察组、对照组治疗后第6个月、12个月、18个月修复优良率分别为100% vs 100%、97.41% vs 85.84%、96.55% vs 83.19%,两组治疗后12、18个月比较差异有统计学意义(P<0.05);治疗后第3个月,两组出血指数(Bleeding index,BI)、菌斑指数(Plaque index,PLI)、牙龈指数(Gingival index,GI)及龈沟液CRP、CXCL16、IL-1β水平均显著降低(P<0.05),且观察组显著低于对照组(P<0.05),两组咀嚼能力显著升高,且观察组显著高于对照组(均P<0.05);观察组患者对修复体满意度(98.34%)显著高于对照组(81.67%)(P<0.05)。结论:CAD/CAM全瓷高嵌体技术应用于修复牙体缺损临床效果显著,可明显改善牙周情况及炎症反应,远期修复效果好,美观度高,患者满意度高,值得临床推广应用。展开更多
AIM: To show the efficacy of reconstruction and rehabilitation of large acquired maxillofacial defects due to tumor resections and firearm injuries. METHODS: The study group comprised of 16 patients(10 men and 6 women...AIM: To show the efficacy of reconstruction and rehabilitation of large acquired maxillofacial defects due to tumor resections and firearm injuries. METHODS: The study group comprised of 16 patients(10 men and 6 women) who were operated on because of their maxillofacial defects under local and general anesthesia between June 2007 and June 2011. Prosthetic treatment with the aid of dental implants was performed for all of the patients. Eight patients received an implant supported fixed prosthesis; six patients received implant supported overdentures and two patients received both. Patients were followed up postoperatively for 1 to 4 years. Implant success and survival rates were recorded. Panoramic radiographs were taken preoperatively, immediately after surgery, immediately after loading and at every recall session. Peri-implant and prosthetic complications were recorded. Subjects were asked to grade their oral health satisfaction after treatment according to 100 mm visual analog scale(VAS) and the oral health related quality oflife of the patients was measured with the short-form Oral Health Impact Profile. RESULTS: Five implants(3 in the mandible, 2 in the maxilla) in five patients were lost, while the other 53 survived, which brings an overall survival rate of 91.37% on the implant basis, but 68.75% on patient basis. All the failed implants were lost before abutment connection and were therefore regarded as early failures. For all failed implants, new implants were placed after a 2 mo period and the planning was maintained. The mean marginal bone loss(MBL) was 1.4 mm on the mesial side and 1.6 mm on the distal side of the implants. Five of the implants showed MBL > 2 mm(mean MBL = 2.3 mm) but less than 1/2 of the implant bodies and therefore were regarded as not successful but surviving implants. The VAS General Comfort mean score was 85.07, the VAS Speech mean score was 75.25 and the VAS Esthetics mean score was 82.74. No patient reported low scores(score lower than 50) of satisfaction in any of the evaluated factors. The mean of OHIP-14 scores was 5.5. CONCLUSION: Although further follow up and larger case numbers will give more information about the success of dental implants as a treatment modality in maxillofacial defects patients, the actual results are encouraging and can be recommended for similar cases.展开更多
文摘目的:对比高嵌体与全冠在修复牙体缺损中的美学效果及预后。方法:选取2020年6月-2022年1月笔者医院收治的牙体缺损患者120例(共229颗患牙),采用随机数字法分为对照组(60例,113颗患牙)和观察组(60例,116颗患牙),对照组采用常规全瓷冠修复治疗,观察组采用CAD/CAM全瓷高嵌体修复治疗,观察两组的修复时间(备牙时间、取模时间和总体操作时间),治疗后第6个月、12个月及18个月的修复效果,以及治疗前、治疗后第3个月牙周指标及龈沟液生化指标[C反应蛋白(C-reactive protein,CRP)、人CXC趋化因子配体16(CXC chemokine ligand 16,CXCL16)、白细胞介素1β(Interleukin-1β,IL-1β)]变化,对比两组牙齿美观满意度。结果:观察组备牙时间、取模时间和总体操作时间均显著低于对照组(P<0.05);观察组、对照组治疗后第6个月、12个月、18个月修复优良率分别为100% vs 100%、97.41% vs 85.84%、96.55% vs 83.19%,两组治疗后12、18个月比较差异有统计学意义(P<0.05);治疗后第3个月,两组出血指数(Bleeding index,BI)、菌斑指数(Plaque index,PLI)、牙龈指数(Gingival index,GI)及龈沟液CRP、CXCL16、IL-1β水平均显著降低(P<0.05),且观察组显著低于对照组(P<0.05),两组咀嚼能力显著升高,且观察组显著高于对照组(均P<0.05);观察组患者对修复体满意度(98.34%)显著高于对照组(81.67%)(P<0.05)。结论:CAD/CAM全瓷高嵌体技术应用于修复牙体缺损临床效果显著,可明显改善牙周情况及炎症反应,远期修复效果好,美观度高,患者满意度高,值得临床推广应用。
文摘AIM: To show the efficacy of reconstruction and rehabilitation of large acquired maxillofacial defects due to tumor resections and firearm injuries. METHODS: The study group comprised of 16 patients(10 men and 6 women) who were operated on because of their maxillofacial defects under local and general anesthesia between June 2007 and June 2011. Prosthetic treatment with the aid of dental implants was performed for all of the patients. Eight patients received an implant supported fixed prosthesis; six patients received implant supported overdentures and two patients received both. Patients were followed up postoperatively for 1 to 4 years. Implant success and survival rates were recorded. Panoramic radiographs were taken preoperatively, immediately after surgery, immediately after loading and at every recall session. Peri-implant and prosthetic complications were recorded. Subjects were asked to grade their oral health satisfaction after treatment according to 100 mm visual analog scale(VAS) and the oral health related quality oflife of the patients was measured with the short-form Oral Health Impact Profile. RESULTS: Five implants(3 in the mandible, 2 in the maxilla) in five patients were lost, while the other 53 survived, which brings an overall survival rate of 91.37% on the implant basis, but 68.75% on patient basis. All the failed implants were lost before abutment connection and were therefore regarded as early failures. For all failed implants, new implants were placed after a 2 mo period and the planning was maintained. The mean marginal bone loss(MBL) was 1.4 mm on the mesial side and 1.6 mm on the distal side of the implants. Five of the implants showed MBL > 2 mm(mean MBL = 2.3 mm) but less than 1/2 of the implant bodies and therefore were regarded as not successful but surviving implants. The VAS General Comfort mean score was 85.07, the VAS Speech mean score was 75.25 and the VAS Esthetics mean score was 82.74. No patient reported low scores(score lower than 50) of satisfaction in any of the evaluated factors. The mean of OHIP-14 scores was 5.5. CONCLUSION: Although further follow up and larger case numbers will give more information about the success of dental implants as a treatment modality in maxillofacial defects patients, the actual results are encouraging and can be recommended for similar cases.
