口腔医学研究 ›› 2024, Vol. 40 ›› Issue (3): 248-253.DOI: 10.13701/j.cnki.kqyxyj.2024.03.011

• 口腔种植学研究 • 上一篇    下一篇

下颌前牙区数字化即刻修复的临床研究

王娜1*, 王超2   

  1. 1.大连市口腔医院种植科 辽宁 大连 116021;
    2.大连市口腔医院修复工艺科 辽宁 大连 116021
  • 收稿日期:2023-07-05 出版日期:2024-03-28 发布日期:2024-03-25
  • 通讯作者: * 王娜,E-mail:79978204@qq.com
  • 作者简介:王娜(1983~ ),女,辽宁本溪人,硕士,副主任医师,研究方向:口腔种植。

Clinical Study on Digital Immediate Restoration in Mandibular Anterior Region

WANG Na1*, WANG Chao2   

  1. 1. Department of Oral Implantology, Dalian Stomatological Hospital, Dalian 116021, China;
    2. Dental Technology Center, Dalian Stomatological Hospital, Dalian 116021, China
  • Received:2023-07-05 Online:2024-03-28 Published:2024-03-25

摘要: 目的:探讨并评估下颌前牙区数字化即刻修复的方法及临床疗效。方法:选择17例下颌2~4颗切牙无法保留的患者为研究对象,种植术前进行系统牙周序列治疗,拍摄锥体束CT (cone-bean CT,CBCT),应用coDiagnostiX软件设计拟植入的种植体三维位置,术前数字化打印手术导板同时预成临时修复体,在导板引导下种植手术,共植入34颗种植体,术中种植体初期稳定性均达到35 N·cm,且ISQ值>65,将预成的临时修复体口内直接法PICK-UP,共完成61颗即刻修复,戴入当日根尖片确认基台完全就位,愈合期内完成定期复查及口腔卫生指导,术后6个月行永久修复,术后12个月评价种植体及修复体存留率、修复体与邻牙牙龈协调性、种植体唇侧骨壁变化及患者美学满意度。结果:观察期12个月内,种植体及修复体存留率为100%,34颗种植体均获得良好的骨结合,种植体唇侧骨壁厚度未见显著变化,55颗修复体唇侧龈缘位置与相邻天然牙协调性良好,6颗修复体轻度差异。56颗修复体与相邻天然牙牙龈颜色质地协调无差异,5颗轻度差异,患者美学视学模拟评分(visual analog scale,VAS)满意度评分平均为96分。结论:在严格适应证选择的基础上,下颌前牙区采用数字化即刻修复,种植美学及功能效果稳定。

关键词: 下颌前牙区, 数字化导板, 即刻修复

Abstract: Objective: To investigate the clinical effectiveness of immediate implantation and immediate restoration with digital workflow in mandibular anterior region. Methods: Seventeen patients with two to four mandibular incisor teeth that could not be retained were selected. Preoperative periodontal therapy was performed, followed by CBCT imaging. The coDiagnostiX software was used to design the three-dimensional position of implants. The surgical guides and provisional restorations were fabricated. A total of 34 implants were implanted, the initial stability of all the implants were ≥35 N·cm, and the ISQ were >65. 61 immediate restorations were performed. Radiographs were taken on the same day to confirm the complete seating of the temporary abutments. Regular follow-ups were conducted to provide oral hygiene instructions. Permanent restorations were performed after 6 months, and after 12 months, the survival rate of implants and restorations, the harmony of gingiva with adjacent teeth, the thickness change of labial bone, and the patient satisfaction degree were evaluated. Results: Within the 12-month observation period, there were no implant failure. All 34 implants achieved good osseointegration during the observation period, with a survival rate of 100% for both the implants and restorations. Among 55 restorations, the labial gingival margin showed good harmony with the adjacent natural teeth, with slight differences observed in 6 restorations. There was no significant difference in gingival color and texture between 56 restorations and the adjacent natural teeth, while 5 restorations showed slight differences. The average patient satisfaction degree with aesthetic visual analog scale (VAS) was 96. Conclusion: Based on strict indications selection, immediate implantation and immediate restoration in the mandibular anterior region can result in stable outcomes.

Key words: mandibular anterior region, digital template, immediate restoration