【摘要】：目的：評(píng)價(jià)平臺(tái)轉(zhuǎn)換連接與對(duì)接連接種植體即刻功能性負(fù)重后短期內(nèi)的邊緣骨喪失情況并探討種植體即刻功能負(fù)重成功率的影響因素,同時(shí)觀察兩組的牙齦變化情況。 方法：選擇因外傷根折、牙體缺損、牙周疾病無(wú)法保留的上下前牙、第一雙尖牙為觀察對(duì)象,拔除后行即刻種植且功能性負(fù)重的患者50例,采用隨機(jī)分組對(duì)照方式,根據(jù)種植體-基臺(tái)連接設(shè)計(jì)不同分為兩組,平臺(tái)轉(zhuǎn)換組25例采用平臺(tái)轉(zhuǎn)換連接技術(shù)的Nobel Active種植體；對(duì)接連接組25例,采用對(duì)接連接技術(shù)的Nobel Replace種植體。兩組患者種植術(shù)后即刻戴入臨時(shí)冠行功能性負(fù)重,12個(gè)月后更換為永久修復(fù)體。所有病例進(jìn)行影像學(xué)檢測(cè)(包括CT、全景片、根尖片),通過影像學(xué)檢測(cè)評(píng)估兩種連接方式的種植體邊緣骨的吸收情況并同時(shí)觀察兩組的牙齦位置變化情況。 結(jié)果：兩組種植體均完成骨及軟組織的結(jié)合,隨訪期內(nèi),種植體無(wú)松動(dòng)、脫落,牙齦組織健康,成功率均為100%。上下前牙拔除后將平臺(tái)轉(zhuǎn)換連接技術(shù)應(yīng)用于即刻種植且即刻功能性負(fù)重的短期臨床效果較佳,平臺(tái)轉(zhuǎn)換連接種植體與對(duì)接連接種植體功能性負(fù)載12個(gè)月時(shí)測(cè)量得到的種植體邊緣骨吸收的均值相比較,平臺(tái)轉(zhuǎn)換組的骨吸收為1.09±0.62mm,對(duì)接連接組的骨吸收為1.43±0.62,P0.05,平臺(tái)轉(zhuǎn)換連接種植體較對(duì)接連接種植體的邊緣骨吸收的數(shù)值均值稍低,但兩組無(wú)明顯統(tǒng)計(jì)學(xué)差異。平臺(tái)轉(zhuǎn)換組與對(duì)接連接組的牙齦位置：術(shù)后戴入臨時(shí)樹脂冠時(shí)測(cè)量均3mm,平臺(tái)轉(zhuǎn)換組3月后基本恢復(fù)正常,探診深度減小到3mm以內(nèi),臨時(shí)冠戴入12個(gè)月時(shí)平臺(tái)轉(zhuǎn)換組的PD為2.68mm,對(duì)接連接組的PD為2.98mmm,P0.05,差異有統(tǒng)計(jì)學(xué)意義,可以認(rèn)為平臺(tái)轉(zhuǎn)換組的牙齦健康狀況優(yōu)于對(duì)接連接組。 結(jié)論：本研究將平臺(tái)轉(zhuǎn)換技術(shù)應(yīng)用于即刻種植且功能性負(fù)重時(shí)短期內(nèi)種植體頸部邊緣骨的吸收同對(duì)接連接雖然無(wú)明顯差異,但牙齦探診深度優(yōu)于對(duì)接連接,其成功率高并可獲得令人滿意的臨床效果,具有較高的臨床應(yīng)用價(jià)值。
[Abstract]:Objective: to evaluate the short-term loss of marginal bone in the implants with immediate functional load and to investigate the influencing factors of the success rate of immediate functional load of the implants, and to observe the gingival changes of the two groups. Methods: the upper and lower anterior teeth which could not be preserved due to traumatic root fracture, tooth defect and periodontal disease were selected as observation objects. The first canine teeth were implanted immediately after extraction, and 50 patients with functional load were randomly divided into two groups. According to the design of implant-base connection, the two groups were divided into two groups: the platform conversion group (25 cases) using the platform conversion connection technique (Nobel Active), and the docking connection group (25 cases) the Nobel Replace implants using the docking connection technique. The patients in both groups were put on temporary crown immediately after implantation and replaced with permanent prosthesis 12 months later. All cases were examined by imaging (including CT, panorama and apical radiography). The resorption of the marginal bone of the implants in two ways of connection was evaluated and the gingival position of the two groups was also observed at the same time. Results: bone and soft tissue were combined in both groups. During the follow-up period, there was no loosening, abscission, healthy gingival tissue, and the success rate was 100%. After the extraction of the upper and lower anterior teeth, the platform-switching connection technique was applied to the short-term clinical effect of immediate implant and immediate functional load. The mean value of bone resorption at the edge of the implants measured at 12 months of functional loading between the platform-switched connective implants and the docking implants was compared. The bone resorption was 1.09 鹵0.62mm in the platform-transition group and 1.43 鹵0.62p0.05 in the docking connection group. The mean value of bone resorption in the platform-switched implant was slightly lower than that in the marginal bone resorption, but there was no significant difference between the two groups. The gingival position of the platform transition group and the docking connection group: the gingival position was 3 mm when the temporary resin crown was put on after operation, and it returned to normal after 3 months in the platform conversion group, and the probing depth was reduced to less than 3mm. The PD of the platform transition group was 2.68 mm, and the PD of the docking connection group was 2.98 mm (P0.05) at 12 months after the temporary crown was worn. The difference was statistically significant. It can be concluded that the gingival health status of the platform transition group is better than that of the docking connection group. Conclusion: although there is no significant difference between the resorption and docking connection of the marginal bone of the implant in the short term, the depth of gingival probing is better than that of the docking connection. It has high success rate and satisfactory clinical effect, and has high clinical application value.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.6

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本文編號(hào)：2244061