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目的 :探讨种植体支持的一体式可拆卸套筒冠固定桥修复无牙的临床效果。方法 :对17例无牙患者,采用一体式可拆卸套筒冠固定桥修复。共制作18个修复体,其中上颌固定桥8例、下颌固定桥10例。分别采用研磨钛基台或全瓷基台、金沉积外冠作为套筒冠内、外冠,全瓷或钴铬合金烤瓷固定桥进行最终修复。分别在戴入固定桥3个月、1年、2年、3年后进行随访,评估种植体周围三维骨吸收情况及软组织健康状况、患者主观满意度及义齿并发症。采用SPSS17.0软件包对所得数据进行统计学分析。结果:共植入127颗种植体,其中,2颗松动,125颗种植体骨水平稳定(垂直向、水平向骨吸收均值分别约为1.2 mm、0.7 mm),种植体留存率达98.43%。单因素方差分析显示,随访期间改良菌斑指数(modified plaque index,m PLI)、改良龈沟出血指数(modified sulcus blooding index,m SBI)无显著差异(P>0.05);探诊附着水平(probing attachment level,PAL)在开始3年内平均增加1.5 mm(P<0.05)。所有患者自觉咀嚼、发音等功能显著提高,心理满意度高。18个修复体固位稳定,无折断、松动现象,2烤瓷冠崩瓷,修理次数0.11次/年/人。结论:种植体支持的无牙一体式可拆卸套筒冠固定桥能较好满足临床需要,近期修复效果稳定。
Objective: To investigate the clinical effect of implant-supported one-piece detachable telescopic crown bridge for the repair of toothless tibia. Methods: Twenty-seven cases of patients without dental floss were repaired by the one-piece detachable sleeve crown fixed bridge. A total of 18 prostheses were made, including 8 cases of maxillary fixed bridge and 10 cases of mandibular fixed bridge. Abrasive titanium-based or all-ceramic abutments and gold-coated outer crowns were used as the final restoration of sleeve crown, outer crown, all-ceramic or cobalt-chromium porcelain fixation bridge respectively. The patients were followed up for 3 months, 1 year, 2 years and 3 years respectively after wearing the fixed bridge to evaluate the three-dimensional bone resorption, soft tissue health, subjective satisfaction and denture complications. SPSS17.0 software package for statistical analysis of the data obtained. Results: A total of 127 implants were implanted. Among them, 2 were loose and 125 implants had stable bone levels (average vertical and horizontal bone resorption were 1.2 mm and 0.7 mm, respectively). The implant retention rate was 98.43%. One-way ANOVA showed no significant difference (m> 0.05) between modified plaque index (m PLI) and modified SBF (multivessel index) during follow-up (P> 0.05) attachment level, PAL) increased by an average of 1.5 mm within the first 3 years (P <0.05). All patients consciously chewing, pronunciation and other functions significantly improved, high psychological satisfaction. 18 prosthesis retention stable, no breakage, loose phenomenon, 2 porcelain crown collapse porcelain, the number of repairs 0.11 times / year / person. Conclusion: The dental implantless one-piece removable sleeve crown fixed bridge can better meet the clinical needs, and the effect of the restoration is stable in the near future.