金基台烤瓷冠在种植修复中应用的临床研究

doi:10.12337/zgkqzzxzz.2022.02.007

摘要/Abstract

摘要： 目的在临床种植修复中,对于牙合龈距为3.5~5.0 mm的种植病例,临床上通过调改成品基台进行修复存在难度。为解决这一临床问题,本研究探讨金基台烤瓷冠修复,以期为解决这类临床问题提供参考。方法临床收集从2013年~2021年间采用个性化的铸造金基台烤瓷冠修复牙合龈距（种植体平台到对颌牙的距离）3.5~5.0 mm的56例病例,共计66颗种植体单冠修复。功能负荷24~72个月期间进行随访,通过观察根尖放射线片和临床检查,分析种植体的留存率、种植并发症的发生率、骨吸收情况以及软组织健康情况。结果应用金基台烤瓷冠修复种植体的留存率为100%;种植工艺并发症的发生率为3%;种植生物学并发症的发生率为21%;种植体周牙槽骨吸收平均值为1.18 mm, 软组织状况良好。结论本研究采用个性化铸造金基台烤瓷螺钉固位的一体冠修复,有效地解决了牙合龈距3.5~5.0 mm的单颗种植修复。

关键词: 种植修复, 金基台, 牙合龈距

Abstract: Objective To review and evaluate clinical results of custom cast gold coping for dental implant restoration in special cases. In clinical application of implant restoration, when the occluso-gingival distance is 3.5-5.0 mm, it is difficult to adjust the stock abutment. In order to solve this clinical problem, this study discusses the implant restoration of porcelain fused to the metal （PFM）crown with a gold abutment, in order to provide a reference for solving this kind of clinical situation. Methods Clinically collected and reviewed 56 cases that the occluso-gingival distance (the distance from the implant shoulder to the opposing teeth） is 3.5-5.0 mm, and a total of 66 single crowns were restored with custom cast gold abutment from 2013 to 2021. The follow-up period during functional loading ranged from 24 to 72 months. Through periapical radiographs with parallel technique, and clinical examinations, the survival rate, incidence of complications, bone resorption around implants, and peri-implant soft tissue were evaluated. Results The survival rate of the implants using the custom cast gold coping is 100%; the incidence of technical complications is 3%; the incidence of biological complications is 21%; the average bone resorption around the dental implant is 1.18 mm, and the soft tissue is healthy. Conclusion In the situation of single implant crown restoration, when the occluso-gingival distance is 3.5-5.0 mm, the screw-retained integrated coping crown with custom cast gold coping can be applied as a reasonable option in this clinical situation.

Key words: Implant restoration, Gold abutment, Occluso-gingival distance

汪霞,唐素霞,彭玲燕,等. 金基台烤瓷冠在种植修复中应用的临床研究[J]. 中国口腔种植学杂志, 2022, 27(1): 34-39. DOI: 10.12337/zgkqzzxzz.2022.02.007

Wang Xia, Tang Suxia, Peng Lingyan, Chen Deping. Clinical research of the application of gold abutments in PFM crowns implant prosthetics[J].Chinese Journal of Oral Implantology, 2022, 27(1): 34-39.DOI: 10.12337/zgkqzzxzz.2022.02.007.

参考文献

[1] Pjetursson BE, Lang NP. Prosthetic treatment planning on the basis of scientific evidence[J]. J Oral Rehabil, 2008,35 Suppl 1:72-79. DOI: 10.1111/j.1365-2842.2007.01824.x.
[2] Tan K, Pjetursson BE, Lang NP, et al.A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years[J]. Clin Oral Implants Res, 2004,15(6):654-666. DOI: 10.1111/j.1600-0501.2004.01119.x.
[3] Jokstad A, Mjör IA.Ten years’clinical evaluation of three luting cements[J]. J Dent, 1996,24(5):309-315. DOI: 10.1016/0300-5712(95)00076-3.
[4] Yu XL, Chan Y, Zhuang L, et al.Intra-oral single-site comparisons of periodontal and peri-implant microbiota in health and disease[J]. Clin Oral Implants Res, 2019,30(8):760-776. DOI: 10.1111/clr.13459.
[5] Lops D, Stellini E, Sbricoli L, et al.Influence of abutment material on peri-implant soft tissues in anterior areas with thin gingival biotype: a multicentric prospective study[J]. Clin Oral Implants Res, 2017,28(10):1263-1268. DOI: 10.1111/clr.12952.
[6] Wheeler SL, Holmes RE, Calhoun CJ.Six-year clinical and histologic study of sinus-lift grafts[J]. Int J Oral Maxillofac Implants, 1996,11(1):26-34.
[7] Hu M, Chen J, Pei X, et al.Network meta-analysis of survival rate and complications in implant-supported single crowns with different abutment materials[J]. J Dent, 2019,88:103115. DOI: 10.1016/j.jdent.2019.04.007.
[8] Sanz-Sánchez I, Sanz-Martín I, Carrillo de Albornoz A, et al. Biological effect of the abutment material on the stability of peri-implant marginal bone levels: a systematic review and meta-analysis[J]. Clin Oral Implants Res, 2018,29 Suppl 18:124-144. DOI: 10.1111/clr.13293.
[9] Serichetaphongse P, Chengprapakorn W, Thongmeearkom S, et al.Immunohistochemical assessment of the peri-implant soft tissue around different abutment materials: a human study[J]. Clin Implant Dent Relat Res, 2020,22(5):638-646. DOI: 10.1111/cid.12942.
[10] 施斌,曾浩.种植修复基台的选择[J].华西口腔医学杂志,2017,35(02):124-126.
[11] 区韵婵, 温灵, 刘宇明, 等. 可铸造基台在颌龈距离不足种植病例中的临床应用观察[J].白求恩医学杂志, 2016, 14(1):53-54. DOI: 10.16485/j.issn.2095-7858.2016.01.025.
[12] Karl M, Irastorza-Landa A.In vitro characterization of original and nonoriginal implant abutments[J]. Int J Oral Maxillofac Implants, 2018,33(6):1229-1239. DOI: 10.11607/jomi.6921.
[13] Alonso-Pérez R, Bartolomé JF, Fraile C, et al. Original versus nonoriginal cast-to-gold abutment-implant connection: analysis of the internal fit and long-term fatigue performance[J]. J Prosthet Dent, 2021,126(1):94.e1-e9. DOI: 10.1016/j.prosdent.2021.03.020.
[14] 刘森庆, 邓飞龙. 种植固定义齿两种固位方式的研究进展[J].中国口腔种植学杂志,2008,13(2):78-80,84. DOI: 10.3969/j.issn.1007-3957.2008.02.010.
[15] Wittneben JG, Millen C, Brägger U. Clinical performance of screw- versus cement-retained fixed implant-supported reconstructions--a systematic review[J]. Int J Oral Maxillofac Implants, 2014,29 Suppl:84-98. DOI: 10.11607/jomi.2014suppl.g2.1.
[16] Shadid R, Sadaqa N.A comparison between screw- and cement-retained implant prostheses. a literature review[J]. J Oral Implantol, 2012,38(3):298-307. DOI: 10.1563/AAID-JOI-D-10-00146.
[17] Kotsakis GA, Zhang L, Gaillard P, et al.Investigation of the association between cement retention and prevalent peri-implant diseases: a cross-sectional study[J]. J Periodontol, 2016,87(3):212-220. DOI: 10.1902/jop.2015.150450.
[18] Sherif S, Susarla HK, Kapos T, et al.A systematic review of screw- versus cement-retained implant-supported fixed restorations[J]. J Prosthodont, 2014,23(1):1-9. DOI: 10.1111/jopr.12128.
[19] Renvert S, Persson GR, Pirih FQ, et al. Peri-implant health, peri-implant mucositis,peri-implantitis: case definitions and diagnostic considerations[J]. J Clin Periodontol, 2018,45 Suppl 20:S278-S285. DOI: 10.1111/jcpe.12956.
[20] Wismeijier D,Buser D, Chen S.ITI Treatment Guide.Volum 8:Biological and hardware complication in implant dentistry[M].Quintessence,2015.
[21] Albrektsson T, Zarb G, Worthington P, et al.The long-term efficacy of currently used dental implants: a review and proposed criteria of success[J]. Int J Oral Maxillofac Implants, 1986,1(1):11-25.
[22] de Brandão ML, Vettore MV, Vidigal Júnior GM. Peri-implant bone loss in cement- and screw-retained prostheses: systematic review and meta-analysis[J]. J Clin Periodontol, 2013,40(3):287-295. DOI: 10.1111/jcpe.12041.