【摘要】：目的:評價埋入式種植體和非埋入式種植體修復(fù)牙列缺損的短期臨床效果,同時評估影響種植體上部結(jié)構(gòu)及周圍組織穩(wěn)定性的各種臨床因素。分析不同愈合方式種植修復(fù)體冠根比和種植體周圍炎癥病史等因素與種植體周圍邊緣骨吸收之間的關(guān)系,為臨床工作中種植體的使用及維護(hù)上部結(jié)構(gòu)的設(shè)計(jì)提供參考依據(jù),提高其臨床效果和遠(yuǎn)期成功率。方法:臨床采用非埋入式種植體和埋入式種植體對178例患者實(shí)施215枚人工種植體,其中包括非埋入式種植體82枚、埋入式種植體133枚,修復(fù)前后,隨訪36個月,在冠修復(fù)當(dāng)天及修復(fù)后第6、12、24、36個月后分別進(jìn)行曲面斷層片檢查。測量下頜后牙區(qū)單顆牙缺失的患者曲面斷層片中種植體邊緣牙槽骨高度和冠根比值,計(jì)算牙槽骨喪失高度。用SPSS17.0軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果:年齡小于55歲的患者最多,為170例,占79.81%,種植部位下頜多于上頜,下頜后牙區(qū)最多,為115例,占53.48%。不同的固位方式出現(xiàn)修復(fù)體機(jī)械性并發(fā)癥的發(fā)生率有明顯差異,其中螺絲固位的種植體發(fā)生機(jī)械性并發(fā)癥的發(fā)生率為19.35%,相應(yīng)粘結(jié)固位的發(fā)生率為7.27%,全部植體冠部結(jié)構(gòu)的成功率為90.70%。回顧3年種植體的失敗率為1.81%,種植牙失敗的原因可能是植體選擇不當(dāng)、早期咬合創(chuàng)傷、不良生活習(xí)慣等。下頜后牙區(qū)單顆牙缺失的病例中,CRR在不同愈合方式間差異不顯著;在不同愈合方式下植體植入3年后種植體周圍骨組織骨吸收量呈不斷增長趨勢,不同愈合方式的植體增長幅度不同;非埋入式植體組邊緣骨吸收量在冠修復(fù)當(dāng)天,修復(fù)后6個月均明顯大埋入式植體組(P0.05);埋入式植體組邊緣骨吸收量在修復(fù)后12個月時骨吸收量大非埋入式種植體組(P0.05),在修復(fù)后24、36個月時,二者之間無明顯差異。兩種愈合方式的植體3年累計(jì)存留率分別為98.74%和97.74%,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:認(rèn)為術(shù)前嚴(yán)格檢查,綜合各因素分析選擇好適應(yīng)證,術(shù)中規(guī)范操作,術(shù)后避免早期咬合創(chuàng)傷,同時指導(dǎo)患者掌握正確的維護(hù)方法是種植成功的前提保障。CRR在不同愈合方式間差異不顯著,兩種愈合方式對種植體周圍骨組織吸收的影響不同,但都有較好的臨床療效。
[Abstract]:Objective: to evaluate the short-term clinical effects of implants and non-implants in the restoration of dentition defects, and to evaluate the clinical factors affecting the stability of the superstructure and surrounding tissues of the implants. To analyze the relationship between the ratio of crown to root and the history of peri-implant inflammation and bone resorption around implants in different healing modes of implants, to provide a reference for the use of implants and the design of superstructure maintenance in clinical work. Improve its clinical effect and long-term success rate. Methods: a total of 215 implants, including 82 implants and 133 implants, were performed on 178 patients with non-embedded implants and implants. The patients were followed up for 36 months. On the day of crown restoration and at the 612 ~ (th) ~ (th), 36 months later, the surface tomograms were examined respectively. The height of alveolar bone and the ratio of crown and root were measured in curved surface tomograph of patients with single missing tooth in mandibular posterior region to calculate the height of alveolar bone loss. Statistical analysis was carried out with SPSS17.0 software. Results: 170 cases (79.81%) were less than 55 years old. The implant site had more mandible than upper jaw and 115 cases (53.48%) had lower posterior teeth. There were significant differences in the incidence of mechanical complications in different retainers. Among them, the incidence of mechanical complications in screw retainer implant was 19.355.The incidence of adhesive retention was 7.27. The success rate of all implant crown structure was 90.70. The failure rate of implant in 3 years was 1.81%. The reasons of dental implants failure may be improper selection of implant, early occlusal trauma, bad living habits and so on. There was no significant difference in CRR among the patients with single tooth loss in the mandibular posterior region, and the bone resorption of the bone tissue around the implant showed an increasing trend after 3 years of implant implantation in different healing modes. The amount of bone resorption at the edge of the non-embedded implant group was the same as that in the crown repair group. The bone resorption of the implant group was significantly larger than that of the control group at 12 months after repair (P0.05), but there was no significant difference between the two groups at 24 and 36 months after repair. The accumulative survival rate of the two kinds of healing methods were 98.74% and 97.74% respectively, the difference was not statistically significant (P0.05). Conclusion: strict examination before operation, comprehensive analysis of various factors, selection of indications, standard operation during operation, prevention of early occlusal trauma after operation, At the same time, guiding the patients to master the correct maintenance method is the premise of successful implants. CRR has no significant difference among different healing modes. The two healing modes have different effects on the bone tissue absorption around the implant, but both have good clinical effect.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R783.6

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