摘要
选取2019年8月至2020年12月于北京大学口腔医学院·口腔医院修复科、牙周科、种植科和门诊部就诊的、计划进行全牙弓即刻种植即刻修复的重度牙周炎患者,探讨牙周夹板结合序列手术导板辅助全牙弓即刻种植即刻修复治疗的技术流程和治疗效果。通过术前颌面部数据采集、系统性诊断设计、牙周夹板固定、导板制作、导板辅助下手术完成全牙弓即刻种植即刻修复8例,上颌7例,下颌1例;男性2例,女性6例,年龄(49.0±9.3)岁(38~65岁);共植入48枚种植体,其中直立植入44枚,倾斜植入4枚;前牙区16枚,后牙区32枚。配准术后锥形束CT和术前设计,测量种植体实际三维位置与术前设计位置的差异,以2 mm为临床可接受的安全范围。术中未见导板折裂或重要解剖结构损伤。种植体冠部和根部整体位移[分别为(0.83±0.48)和(1.36±0.57)mm]在临床可接受的安全范围内。冠部水平和垂直位移、根部水平和垂直位移以及种植体长轴角度的前后牙区差异均无统计学意义(P>0.05)。牙周夹板结合序列手术导板辅助重度牙周炎患者全牙弓即刻种植即刻修复可拓展全牙弓种植手术的适应证,满足在临床应用的安全性要求。
To explore the technical process and the therapeutic effect of using sequential surgical guide with independent intellectual property rights assisting immediate implantation and restoration of the full arch,with the support from the periodontal splint for mobile supporting teeth,patients with severe periodontitis who planned to undergo immediate full arch implantation were recruited from August 2019 to December 2020 at the Department of Prosthodontics,Department of Periodontology,Department of Implantology and First Clinical Division,Peking University School and Hospital of Stomatology.Through the procedure of collecting preoperative maxillofacial data,making systematic diagnostic design,making periodontal splints fixation,producing surgical guide,and carrying out guided surgery for full arch immediate implantation,eight cases were included.By registering the postoperative cone-beam CT(CBCT)with the preoperative data,the difference between the actual three-dimensional position of the implants and the virtual design was observed,and the accuracy of the implant placement position guided by the sequential guide was statistically analyzed using SPSS 25.0 software.Analysis indicators include coronal and apical global displacement,coronal horizontal and vertical displacement,apical horizontal and vertical displacement,and angular deviation.Results revealed that the 8 patients[2 males and 6 females,aged(49.0±9.3)years(38-65 years)]of recruited cases included 7 cases of maxilla and 1 cases of mandible.A total of 48 implants,of which 44 implants were placed upright and 4 were placed tilted,16 implants in the anterior region and 32 implants in the posterior region.No guide plate fracture or damage to important anatomical structures were reported.The overall displacement at the coronal point[(0.83±0.48)mm]and the global displacement at the apical point[(1.36±0.57)mm]were within the clinically acceptable safety range,and the horizontal displacement and vertical displacement at the coronal point,horizontal displacement and
作者
杨静文
侯建霞
刘建彰
张宇
陈全
赵一姣
王勇
Yang Jingwen;Hou Jianxia;Liu Jianzhang;Zhang Yu;Chen Quan;Zhao Yijiao;Wang Yong(Department of Prosthodontics,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;Department of Periodontology,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;Department of Implantology,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;First Clinical Division,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100034,China;Center for Digital Dentistry,Faculty of Prosthodontics,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2021年第6期576-580,共5页
Chinese Journal of Stomatology
基金
宁夏回族自治区重点研发计划重大(重点)项目(2018BEG02012)
兰州市人才创新创业项目(2019-RC-22)
北京大学口腔医院临床新技术新疗法普通项目(PKUSSNCT-19B11)。
关键词
牙种植
牙周炎
牙周夹
夹板
即刻种植
即刻修复
Dental implantation
Periodontitis
Periodontal splints
Splints
Immediate implantation
Immediate restoration
