基于颧种植技术的无牙上颌新分类及即刻负荷解决方案

doi:10.12337/zgkqzzxzz.2025.06.002

中国口腔种植学杂志 ›› 2025, Vol. 30 ›› Issue (3): 203-208.DOI: 10.12337/zgkqzzxzz.2025.06.002

基于颧种植技术的无牙上颌新分类及即刻负荷解决方案

吴轶群¹, 王凤², 陶宝鑫¹

¹上海交通大学医学院附属第九人民医院口腔第二门诊部上海交通大学口腔医学院国家口腔医学中心国家口腔疾病临床医学研究中心上海市口腔医学重点实验室上海市口腔医学研究所中国医学科学院口腔颌面再生医学创新单元 200001;
²香港大学牙医学院口腔颌面外科

收稿日期:2025-01-14 出版日期:2025-06-30 发布日期:2025-06-27
通讯作者: 吴轶群,Email：yiqunwu@hotmail.com,电话：021-56691101-7540
作者简介:吴轶群,口腔医学博士,主任医师,博士研究生导师,上海交通大学医学院附属第九人民医院口腔第二门诊部主任; 中华口腔医学会口腔种植专业委员会副主任委员,国际口腔种植协会专家委员会委员（ITI Fellow）,国际口腔种植协会中国分会主席,国际口腔种植协会上海奖学金中心主任（ITI Scholarship Centre）,上海交通大学医学院附属第九人民医院-爱丁堡皇家外科学院口腔种植与修复培训考试中心主任; 十三五国家重点研发项目课题负责人,主持国家自然科学基金、国际口腔种植协会（ITI）资助项目等多项国家级、国际级课题项目,研究成果曾获得国家科技进步二等奖（2019）、中华口腔医学会科技奖三等奖（2018）、华夏医学奖三等奖（2016）,上海市科技进步奖一等奖（2010）等; 发表论文80余篇,参编著作10部。
基金资助:
上海市重中之重研究中心（2022ZZ01017）; 中国医学科学院医学与健康科技创新工程项目（2019-I2M-5-037）; 申康促进市级医院临床技能与临床创新能力三年行动计划（SHDC2020CR3049B）; 上海交通大学医学院附属第九人民医院临床研究助推计划（临+计划）面上项目（JYLJ202412）

A new classification of the edentulous atrophic maxillae based on zygomatic implant surgery and immediate loading protocols

Wu Yiqun¹, Wang Feng², Tao Baoxin¹

¹Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology & Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200001, China;
²Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China

Received:2025-01-14 Online:2025-06-30 Published:2025-06-27
Contact: Wu Yiqun, Email: yiqunwu@hotmail.com, Tel: 0086-21-56691101-7540
Supported by:
Shanghai's Top Priority Research Center (2022ZZ01017); CAMS Innovation Fund for Medical Sciences (CIFMS) (2019-I2M-5-037); Clinical Research Plan of SHDC (SHDC2020CR3049B); Clinical Research Program of 9th People's Hospital, Shanghai Jiao Tong University School of Medicine (JYLJ202412)

摘要/Abstract

摘要： 无牙颌的即刻负荷一直是临床热点问题,中重度萎缩的无牙上颌种植即刻负荷更是热点中的难点。尽管无牙上颌种植即刻负荷的可靠性已逐渐得到更多文献证实,但在上颌骨量明显不足时,如何实现即刻负荷就显得极其重要且充满挑战。国内外虽提出了多种无牙上颌分类方法以满足无牙颌种植即刻负荷的可行性和安全性,但这些分类方法仍无法涵盖所有临床病例的复杂情况,也难以在临床工作中为方案选择提供明确指导。本文基于近年来颧种植技术的长足发展,提出了基于颧种植技术的无牙上颌新分类及其可实现即刻负荷的种植方案：1. 上颌双侧第二前磨牙（5-5）区域骨量充足,无需骨增量能够植入至少4颗常规种植体,可采用倾斜种植实现即刻负荷;2. 上颌双侧第一前磨牙（4-4）区域骨量充足,无需骨增量能够植入至少2颗常规种植体,可采用前牙区2~4颗常规种植结合双侧后牙区单颧种植实现即刻负荷;3. 上颌双侧第二前磨牙（5-5）区域骨量不足,而双侧第一、第二磨牙（6、7）区域骨量充足,每侧无需骨增量至少能够植入1颗常规种植体,可采用双侧前牙区颧种植、后牙区常规种植实现即刻负荷;4. 上颌整体（7-7）区域骨量不足,可采用双侧双颧种植实现即刻负荷。该分类及实现即刻负荷的种植方案旨在涵盖无牙上颌各种复杂临床情况,为无牙上颌种植即刻负荷的方案选择提供参考。

关键词: 颧种植, 无牙颌, 即刻负荷, 种植修复, 临床决策

Abstract: Immediate loading in edentulous maxillae remains a clinical focus, particularly challenging in cases with moderate to severe atrophy. While the effectiveness of dental implants for immediate loading of the edentulous maxillae has been increasingly proven, accomplishing this in cases with inadequate bone volume is notably important and presents a significant challenge. Multiple methods have been proposed to achieve feasibility and safety for immediate loading of edentulous jaws, however, they can neither meet the complex situations of various clinical cases nor provide clear guidance for protocol selection in clinical practice. This article is based on the significant development of zygomatic implant surgery in recent years and proposes a new classification of the edentulous maxillae based on zygomatic implant surgery and corresponding immediate loading protocols. The classification and immediate loading protocols are as follows: 1. The bone volume in the bilateral second premolar area (5-5) is sufficient, and at least four conventional dental implants, including tilted implants, can be placed without bone augmentation to achieve immediate loading; 2. The bone volume in the first premolar area (4-4) on both sides is sufficient, and at least two conventional dental implants can be inserted without bone grafting. Immediate loading can be achieved by combining 2-4 conventional dental implants in the anterior area with zygomatic implants in both posterior regions; 3. There is insufficient bone volume in the second premolar area (5-5) on both sides, while the bone volume in the molar areas is sufficient, and at least one conventional dental implant can be placed on each molar side. Zygomatic implants are used in the anterior area on both sides, and conventional implants are used in the posterior areas to achieve immediate loading;4. Insufficient volume is observed in the full maxilla (7-7). Immediate loading can be achieved by quad zygomatic implant surgery. This classification and the corresponding immediate loading protocols aim to cover various complex clinical scenarios of edentulous maxillae, providing a reference and indication for the selection of immediate loading plans for these patients.

Key words: Zygomatic implant, Edentulous jaws, Immediate loading, Implant-supported restoration, Clinical decision-making

吴轶群,王凤,陶宝鑫. 基于颧种植技术的无牙上颌新分类及即刻负荷解决方案[J]. 中国口腔种植学杂志, 2025, 30(3): 203-208. DOI: 10.12337/zgkqzzxzz.2025.06.002

Wu Yiqun, Wang Feng, Tao Baoxin. A new classification of the edentulous atrophic maxillae based on zygomatic implant surgery and immediate loading protocols[J].Chinese Journal of Oral Implantology, 2025, 30(3): 203-208.DOI: 10.12337/zgkqzzxzz.2025.06.002.

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基于颧种植技术的无牙上颌新分类及即刻负荷解决方案

A new classification of the edentulous atrophic maxillae based on zygomatic implant surgery and immediate loading protocols

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