【摘要】：近年，隨著口腔材料的發(fā)展，氧化鋯逐步取代烤瓷熔附金屬、氧化鋁等修復(fù)材料，成為修復(fù)領(lǐng)域中具有廣闊發(fā)展前景的生物材料。氧化鋯具有較高的機械強度，撓曲強度達到900-1200Mpa，抗壓強度達到2000Mpa，化學(xué)性能穩(wěn)定，又由于氧化鋯生物相容性良好、制作精度高、不影響磁共振成像、強度大等諸多優(yōu)點而廣泛地應(yīng)用于口腔臨床。用于前牙的美學(xué)修復(fù)時，具有明顯的美學(xué)優(yōu)勢。但是，應(yīng)用于后牙時，其臨床效果受到材料相關(guān)的并發(fā)癥的影響，目前，是否推薦用于后牙冠修復(fù)尚未有定論，尤其在種植領(lǐng)域，相關(guān)的臨床研究尚不多見。 而且氧化鋯本身具有剛性，沒有與金屬或烤瓷熔附金屬修復(fù)體一樣對咬合存在逐漸適應(yīng)的過程，若處于后牙區(qū)咬合力量大的位置，在長期的循環(huán)負載過程中，可能會增加氧化鋯全瓷修復(fù)出現(xiàn)并發(fā)癥的風(fēng)險。再加上種植體根部缺少類似牙周韌帶的組織，對咬合力缺乏緩沖機制，導(dǎo)致種植體周圍骨組織受到一定應(yīng)力，而可能發(fā)生骨水平的改變。因此，，氧化鋯全瓷運用于后牙種植修復(fù)的效果及其對種植體周圍組織健康的影響是值得研究的一項課題。 實驗一氧化鋯全瓷修復(fù)體在后牙種植區(qū)應(yīng)用的臨床效果評價 目的:本實驗通過回顧性研究在后牙種植區(qū)完成氧化鋯全瓷修復(fù)的臨床和影像學(xué)資料，評價氧化鋯全瓷修復(fù)應(yīng)用于后牙種植的臨床使用效果。 方法:本研究收集自2011年07月至2012年06月陜西省內(nèi)在第四軍醫(yī)大學(xué)口腔醫(yī)院種植科采用氧化鋯全瓷進行后牙種植修復(fù)的臨床病例和影像學(xué)資料，對323位患者（387個修復(fù)體，528顆種植體）進行回顧性研究。檢查修復(fù)體完整性、密合性、牙齦狀況，檢測改良齦溝出血指數(shù)（mSBI）、改良菌斑指數(shù)（mPLI）、牙周探診深度（PD），詳細記錄種植體和修復(fù)體的存留狀況。使用SPSS18.0對數(shù)據(jù)進行統(tǒng)計分析。 結(jié)果:隨訪患者264位（81.7%），修復(fù)體315個（81.4%），種植體423顆（80.1%）。平均隨訪時間18.8±3.8個月（12～28個月）。修復(fù)體機械并發(fā)癥總體發(fā)生率8.0%。24個修復(fù)體（9.1%）發(fā)生崩瓷，1個修復(fù)體（0.3%）發(fā)生脫落。種植體累計存留率100%。隨訪期內(nèi)未發(fā)現(xiàn)種植體發(fā)生松動、折斷、脫落。改良齦溝出血指數(shù)（mSBI）平均值0.45±0.78（0～3），改良菌斑指數(shù)（mPLI）平均值0.35±0.73（0～3），PD平均值2.74±1.08mm（1～7mm）。14顆（3.3%）種植體出現(xiàn)種植體周圍粘膜炎表現(xiàn)。 結(jié)論:種植單冠支持的氧化鋯全瓷修復(fù)后牙單牙缺失可以達到良好的修復(fù)效果。但是，由于全氧化鋯瓷不存在瓷層結(jié)合強度等問題，而且強度高，若患者不考慮美觀，則推薦用于后牙多牙連續(xù)缺失的修復(fù)。 實驗二后牙種植區(qū)氧化鋯全瓷修復(fù)影響種植體邊緣骨吸收的臨床研究 目的:探討氧化鋯全瓷修復(fù)的相關(guān)受力因素對種植體邊緣骨吸收的影響。 方法:收集自2011年07月至2012年06月陜西省內(nèi)在第四軍醫(yī)大學(xué)口腔醫(yī)院種植科采用氧化鋯全瓷進行后牙種植修復(fù)的臨床病例和影像學(xué)資料，對323位患者（387個修復(fù)體，528顆種植體）進行回顧性研究。分別測量戴牙當(dāng)日和隨訪當(dāng)日的X線片中種植體周圍邊緣骨水平至基臺平面的垂直距離，獲得該時間段內(nèi)邊緣骨水平的變化。使用多元線性回歸分析種植體邊緣骨吸收的影響因素。 結(jié)果:種植體從功能負載后一年至隨訪時間，MBL平均值（0.28±0.35）mm，最大值1.97mm，最小值0mm。通過多元回歸分析，種植修復(fù)方式（P=0.023）和對頜牙類型（P=0.030）對MBL有影響。進一步分析，對頜為自然牙的種植單冠的種植體品牌（P=0.016），種植聯(lián)冠的種植體位置（P=0.021）、修復(fù)體崩瓷情況（P=0.004）、牙周病史（P=0.035），種植固定橋的種植體位置（P=0.006）可能影響MBL。不同對頜類型的MBL的差異可能受到年齡、種植體位置、品牌等變量的影響。 結(jié)論:在氧化鋯全瓷修復(fù)的咬合受力下，種植體周圍未發(fā)生損傷性的邊緣骨吸收。種植修復(fù)方式和對頜牙類型是MBL的影響因素。在探診出血以及上頜磨牙的種植體中，種植聯(lián)冠相對種植單冠的邊緣骨吸收更多。對頜種植固定義齒的種植體邊緣骨吸收高于對頜自然牙的種植體。在上頜straumann種植體中，這種差異更明顯。
[Abstract]:In recent years, with the development of oral material, the oxidation of the metal, alumina and other repair materials has become a promising biomaterial in the field of repair. the oxidizing agent has higher mechanical strength, the flexural strength reaches 900-1200Mpa, the compressive strength reaches 2000Mpa, the chemical property is stable, and the oxidizing agent has the advantages of good biocompatibility, high manufacturing precision, no influence on magnetic resonance imaging, large intensity and the like, and is widely applied to the oral clinic. When used for the aesthetic restoration of the front teeth, the invention has the obvious aesthetic advantage. However, when applied to the posterior teeth, its clinical effect is affected by the material-related complications. At present, it is not clear whether it is recommended for posterior dental crown repair, especially in the field of planting. and the oxidizing agent itself has the rigidity, does not have the process of gradually adapting to the bite due to the metal or porcelain fused metal repairing body, and if the position of the biting force of the posterior tooth area is large, the process of the long-term cyclic loading In addition, it is possible to increase the wind of the complication of the whole-ceramic restoration of the oxidized silicon oxide. Risk. Combined with the absence of a tissue similar to the periodontal ligament at the root of the implant, the lack of a cushioning mechanism to the biting force results in a certain stress on the bone tissue surrounding the implant, which may lead to a change in the bone level Therefore, the effect of the application of the full-ceramic oxide on the restoration of the post-implant and its effect on the health of the surrounding tissue of the implant is one of the lessons to be studied A clinical study on the application of a full-ceramic restoration in the posterior tooth-growing area Objective: To evaluate the clinical and imaging data of the complete porcelain restoration in the post-dental implant area, and to evaluate the application of the full-ceramic restoration in the post-dental implant to the post-dental implant. Methods: This study collected the clinical and imaging data from July 2011 to June 2012 in the Department of Stomatology of the Fourth Military Medical University in Shaanxi Province. The clinical and imaging data of the restoration of post-dental implant in the Department of Stomatological Hospital of the Fourth Military Medical University were carried out in Shaanxi Province, and 323 patients (387 restorations, 528 implants) were collected. A retrospective study was performed to examine the integrity, adhesion, and gingival conditions of the prosthesis, the modified gingival crevicular index (mSBI), the modified plaque index (mPLI), the depth of the periodontal examination (PD), and the detailed recording of the implant and repair. The persistence of the complex. Using the SPSS18. 0 log Results: 264 patients (81.7%) and 315 (81.4%) of the patients were followed up, and the implant 42 3 (80.1%). The average follow-up time was 18. 8 to 3. 8 months. (12-28 months). The overall incidence of repair mechanical complications was 80.0%. 0. 3%) Dropped. Implant The cumulative retention rate was 100%. The implant was not found during the follow-up period The mean value of modified gingival crevicular index (mSBI) was 0.45-0.78 (0-3), the modified plaque index (mplI) was 0.35-0.73 (0-3), the average of PD was 2.74-1.08mm (1-7mm), and 14 (3. 3%) implants appeared. The results of the surrounding mucositis of the implant body. Conclusion: The single-tooth missing tooth is missing after the full-ceramic restoration with single-crown support. good repair effect can be achieved, The repair of the continuous deletion of the posterior teeth with multiple teeth. The purpose of the clinical study of the bone resorption in response to the edge of the implant: to study the correlation of the full-ceramic repair of the oxide The effect of the force factor on the bone resorption of the implant was collected from July 2011 to June 2012. The clinical and imaging data of the post-dental implant repair in the Department of Stomatology of the Fourth Military Medical University in Shaanxi Province from July 2011 to June 2012 were collected, and 323 patients (387 were repaired) A retrospective study of the body, 528 implants). The vertical spacing of the peri-implant peripheral edge bone level to the base platform plane on the day of the day of wear and the date of follow-up, respectively, was measured. A change in the level of the edge bone in the time period is obtained. Multiple linearity is used Regression analysis of the effects of implant-edge bone resorption. Results: The mean time of the implant from the functional load to the follow-up time and the mean value of MBL (0.28-0.35) mm, max. 1.97mm, min. 0mm. Through multiple regression analysis, planting repair (P = 0.023) and jaw The dental type (P = 0.030) has an effect on MBL. Further analysis, the implant brand (P = 0.016), the implant position of the crown (P = 0.021), the repair body collapse (P = 0. 004), the history of periodontal disease (P = 0.035) and the planting of the fixed bridge were also analyzed. Body position (P = 0. 006) may affect the MBL. The difference in MBL of the different pair of jaw types may The effects of age, implant location, brand, etc. Conclusion: The occlusion of the full-ceramic repair of the oxidized silicon At the force of the implant, there was no marginal bone resorption around the implant. Planting and repairing methods and the influence factors on the type of the jaw teeth are MBL. In the diagnosis and diagnosis of bleeding and the planting of the maxillary molars In the body, the crown of the plant is more absorbed by the marginal bone of the single crown. The implant marginal bone of the tooth is higher than the implant for the natural tooth of the jaw. In the upper jaw
【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R783.6

【共引文獻】

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9 韓R

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