口腔医学研究 ›› 2024, Vol. 40 ›› Issue (4): 349-355.DOI: 10.13701/j.cnki.kqyxyj.2024.04.013

• 口腔种植学研究 • 上一篇    下一篇

T-Scan分析单颗后牙种植修复体咬合对垂直骨吸收的影响

方利1, 陈梓俊1, 王宇曦1, , 张冠华1, 刘向东1, 邓邦莲2, 宋应亮1*   

  1. 1.口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔生物工程工程技术中心,空军军医大学第三附属医院种植科 陕西 西安 710032;
    2.西安联邦口腔医院 陕西 西安 710032
  • 收稿日期:2024-01-05 发布日期:2024-04-22
  • 通讯作者: *宋应亮,E-mail;songyingliang@163.com
  • 作者简介:方利(1994~ ), 女, 宁夏中卫人, 硕士, 主要从事临床种植与相关风险因素研究。
  • 基金资助:
    国家自然科学基金(82170991)

Analysis on Effect of Occlusion of Single Posterior Implant on Vertical Bone Loss with T-Scan

FANG Li1, CHEN Zijun1, WANG Yuxi1, ZHANG Guanhua1, LIU Xiangdong1, DENG Banglian2, SONG Yingliang1*   

  1. 1. State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration; National Clinical Research Center for Oral Diseases; Shaanxi Engineering Research Center for Dental Materials and Advanced manufacture; Department of Implantology,The Third Affiliated Hospital of Air Force Medical University, Xi'an 710032, China;
    2. Xi'an Federal Stomatological Hospital, Xi'an 710032, China
  • Received:2024-01-05 Published:2024-04-22

摘要: 目的: 利用T-Scan定量分析单颗后牙种植修复体在牙尖交错位(intercuspal position,ICP)时咬合接触情况,并探讨其对种植体周围垂直骨吸收的影响。方法: 选取第一磨牙常规种植修复的40例无咬合高点等不良修复现象和磨牙症等不良习惯的患者。T-Scan记录种植修复体及对侧同名牙咬合接触情况的差异,分别按照咬合延迟时间、牙合力百分率比、咬合力峰值及咬合接触面积比进行分组,用影像学测量技术评估种植体周围骨组织的变化,从而分析咬合因素对种植体周围垂直骨吸收(vertical bone loss,VBL)的影响,并建立多元线性回归模型。结果: 在咬合延迟时间和咬合力峰值分组比较中,平均VBL均存在显著性差异(P<0.05)。同时得出预测方程:Y=1.060-0.734X1+0.248X2-0.589X3,其中Y为平均VBL、X1为咬合延迟时间、X2为咬合力峰值、X3为咬合接触面积比。结论: 在单颗后牙缺失常规种植修复时除考虑适当的咬合设计外,在调整种植修复体的咬合接触或定期咬合检查时,推荐应用T-Scan进行定量分析以确保ICP时咬合力峰值尽可能降低(即轻咬合接触),和适当延迟种植修复体首次咬合接触时间,对维持种植体周围骨的稳定性极为有益。

关键词: 单颗后牙, 咬合, 咬合接触, 咬合负荷, 量化分析, 垂直骨吸收

Abstract: Objective: To quantitatively analyze the occlusal contact of single posterior implant prosthesis in the intercuspal position(ICP), and to explore its effect on vertical bone loss around the implant. Methods: Forty patients without a adverse repair phenomena such as early contact and bad habits such as bruxism were selected for conventional implant restoration of the first molar. The T-Scan occlusal analyzer was used to record the difference in occlusal contact between the implant prosthesis and the contralateral homonymous tooth.They were grouped according to occlusal delay time, percentage ratio of occlusal force, peak occlusal force, and occlusal contact area ratio. The effect of occlusion on vertical bone loss(VBL) around the implant was analyzed, and a multiple linear regression model was established. Results: There were significant differences in the average VBL between groups in the comparison of the occlusal delay time and the peak bite force (P<0.05). At the same time, the prediction equation was obtained: Y=1.060-0.734X1 + 0.248X2-0.589X3, where Y is average VBL, X1 is occlusal delay time, X2 is peak bite force, and X3 is occlusal contact area ratio. Conclusion: In addition to considering the appropriate occlusal design in the implant restoration, when adjusting the occlusal contact of implant restorations or during regular occlusal examinations,the application of T-Scan is recommended,to minimize the peak occlusal force (light occlusal contact) at ICP, and to delay the first occlusal contact time of the implant restorations as much as possible, which is extremely beneficial to maintain the stability of the peri-implant bone.

Key words: single posterior tooth, occlusal, occlusal contact, occlusal load, quantitative analysis, vertical bone loss