口腔医学研究 ›› 2020, Vol. 36 ›› Issue (10): 957-961.DOI: 10.13701/j.cnki.kqyxyj.2020.10.016

• 口腔种植学研究 • 上一篇    下一篇

“All-on-4”种植即刻固定修复后下颌骨生物学改建模式的影像学研究

贾胜男, 邸萍, 林野*   

  1. 北京大学口腔医院种植科 北京 100081
  • 收稿日期:2020-06-19 出版日期:2020-10-28 发布日期:2020-10-19
  • 通讯作者: *林野,E-mail:yorcklin@263.net
  • 作者简介:贾胜男(1989~ ),女,浙江人,博士,住院医师,从事种植修复临床和教学工作。
  • 基金资助:
    首都卫生发展科研专项基金(编号:2018-2-4102)

Remodeling Pattern of Mandible after “All-on-4” Immediate Fixed Rehabilitation: A Radiographic Study

JIA Shengnan, DI Ping, LIN Ye*   

  1. Department of Oral Implantology, Peking University Hospital of Stomatology, Beijing 100081, China
  • Received:2020-06-19 Online:2020-10-28 Published:2020-10-19

摘要: 目的: “All-on-4”种植即刻固定修复后下颌骨生物学改建模式及其影响因素的影像学研究,并分析生物力学改变。方法: 纳入30例下颌行“All-on-4”种植即刻固定修复并随访1年以上的患者,于修复完成后及每年随访时拍摄曲面体层片。采用二维影像学评价方法,在曲面体层片上依据下颌骨解剖标志点及植入种植体在下颌骨上定位7个测量点,并逐一测量下颌骨的垂直高度,分别代表:M(中线处),ML/MR(同侧近远中种植体之间),L1/R1(磨牙区),L2/R2(磨牙后区),计算下颌不同位置剩余牙槽骨的年吸收率。对患者年龄、性别、下颌骨原始高度、咬合力等可能影响下颌骨改建的因素进行相关性分析。结果: ML、M、MR处垂直骨高度少量降低[ML:(-0.02±0.33) mm/年;M:(-0.15±0.27) mm/年;MR:(-0.02±0.22) mm/年];L1/R1处垂直骨高度增长[L1:(0.25±0.57) mm/年,R1:(0.21±0.61) mm/年];L2/R2处垂直骨高度少量增长[L2:(0.07±0.58) mm/年,R2:(0.01±0.52) mm/年]。此外,应用相关性分析,对颌牙的咬合力与L1/R1牙槽骨垂直高度变化正相关(P<0.05)。结论: “All-on-4”种植即刻固定修复方式改变了下颌无牙颌剩余牙槽骨吸收改建的过程与模式,颏孔间植入种植体即刻固定修复方式降低了下颌颏孔间剩余牙槽骨的吸收速率,而下颌骨磨牙区有垂直骨高度的增长。

关键词: 牙槽骨吸收, 牙种植体, 植入物支持义齿, All-on-4

Abstract: Objective: To investigate the pattern of mandible remodeling after “All-on-4” immediate fixed rehabilitation and its influential factors. Methods: 30 patients rehabilitated with “All-on-4” implant-supported fixed restorations were studied. All patients were followed-up for more than 1 year. Panoramic radiographs (OPT) were taken after the completion of prosthetic restoration and during the follow-up period. The samples were investigated by 2-dimensional radiological retrospective analysis. 7 sites on the mandible were marked (M: mid-line site; ML/MR: the sites between two implants on the same side; L1/R1: molar sites; L2/R2: retromolar sites) based on the anatomical landmarks and the locations of implants on the OPTs. The vertical bone heights were measured and the average annual bone resorption rates were calculated on these 7 sites. Correlation analysis was conducted for age, gender, initial mandibular height, and chewing force, respectively. Results: Bone resorption was observed on sites ML, M, and MR [ML:(-0.02±0.33) mm/year;M:(-0.15±0.27) mm/year;MR:(-0.02±0.22) mm/year]. Bone augment was discovered at L1/R1 [L1: (0.25±0.57) mm/year, R1: (0.21±0.61) mm/year]. While slight alveolar height increments were recorded at L2/R2 [L2: (0.07±0.580 mm/year, R2: (0.01±0.52) mm/year]. Furthermore, chewing force was positively correlated with the height changes at site L1/R1 (P<0.05). Conclusion: “All-on-4” immediate fixed rehabilitation may change the mandible remodeling pattern. Placing implants between the mental foramen contributes to the lower resorption rate in the area between mental foramen and fixed rehabilitation contributes to the increments of vertical bone height at the molar sites of the mandible.

Key words: alveolar bone loss, dental implants, implant-supported dental prosthesis, all-on-4