翼上颌区种植体联合前部种植体修复萎缩上颌无牙颌的临床回顾研究

doi:10.7518/hxkq.2021.03.007

华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (3): 286-292.doi: 10.7518/hxkq.2021.03.007

翼上颌区种植体联合前部种植体修复萎缩上颌无牙颌的临床回顾研究

吴瑾¹(), 刘堃¹^,², 李明¹, 朱志军¹, 汤春波¹()

^1.南京医科大学口腔疾病研究江苏省重点实验室南京医科大学附属口腔医院种植科，南京 210029
^2.安徽医科大学合肥口腔临床学院，合肥市口腔医院种植科，合肥 230001

收稿日期:2020-04-29 修回日期:2020-12-19 出版日期:2021-06-01 发布日期:2021-05-26
通讯作者: 汤春波 E-mail:jennyfour0823@126.com;cbtang@njmu.edu.cn
作者简介:吴瑾，硕士，E-mail：jennyfour0823@126.com
基金资助:
国家自然科学基金(81470778);南京市科技发展计划项目(201605011);东大?南医大合作研究项目(2242018K3DN03)

Clinical assessment of pterygoid and anterior implants in the atrophic edentulous maxilla: a retrospective study

Wu Jin¹(), Liu Kun¹^,², Li Ming¹, Zhu Zhijun¹, Tang Chunbo¹()

^1.Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University & Dept. of Dental Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
^2.Dept. of Dental Implantology, Hefei Stomatological Hospital, Hefei Stomatological Clinical College of Anhui Medical University, Hefei 230001, China

Received:2020-04-29 Revised:2020-12-19 Online:2021-06-01 Published:2021-05-26
Contact: Tang Chunbo E-mail:jennyfour0823@126.com;cbtang@njmu.edu.cn
Supported by:
The National Natural Science Foundation of China(81470778);The Science and Technology Commission Programme of Nanjing(201605011);The Southeast University and Nanjing Medical University Cooperative Research Project(2242018K3DN03)

摘要/Abstract

摘要： 目的

评估翼上颌区种植体联合前部种植体修复后部萎缩的上颌无牙颌的短期临床效果及患者的满意度。

方法

回顾性研究筛选25例行前部和翼上颌区种植体支持的上颌固定修复并随访1年以上的上颌无牙颌患者作为研究对象，观察种植体存留率、种植体周软组织状态（包括探诊深度，改良龈沟出血指数，菌斑指数）、边缘骨吸收以及患者的满意度。

结果

前部和翼上颌区种植体的1年存留率分别为96.5%和97.8%（P>0.05）。2种种植体的探诊深度、改良龈沟出血指数、菌斑指数的差异均无统计学意义（P>0.05）。前部种植体的边缘骨吸收为0.62 mm±0.44 mm（近中）和0.61 mm±0.40 mm（远中），翼上颌区种植体的边缘骨吸收为0.64 mm±0.46 mm（近中）和0.68 mm±0.41 mm（远中），2种种植体近中、远中边缘骨吸收的差异均无统计学意义（P>0.05）。患者对前部与翼上颌区种植体支持的上颌全牙弓义齿具有较高的满意度。

结论

对于后部萎缩的上颌无牙颌，前部和翼上颌区种植体支持的全牙弓固定义齿具有可以接受的短期临床效果和较高的患者满意度，是一种可预测的和可行的修复方式。

关键词: 翼上颌区种植体, 翼上颌区域, 上颌无牙颌, 边缘骨吸收

Abstract: Objective

This study aims to evaluate the short-term clinical outcomes and patient satisfaction of anterior and pterygoid implants in the rehabilitation of edentulous maxilla with posterior atrophy.

Methods

Given a minimum follow-up of 1 year, 25 patients with fixed maxillary rehabilitation over anterior and pterygoid implants were enrolled in this retrospective study. The implant survival rates, peri-implant soft tissue status (including probing depth, modified sulcus bleeding index, and plaque index), marginal bone loss, and patient satisfaction were measured.

Results

The survival rates for anterior and pterygoid implants at 1-year follow-up were 96.5% and 97.8%, respectively (P>0.05). No statistically significant difference in probing depth, modified sulcus bleeding index, and plaque index was observed between the two types of implants (P>0.05). The marginal bone losses of anterior implants were 0.62 mm± 0.44 mm (mesial) and 0.61 mm± 0.40 mm (distal), and those of pterygoid implants were 0.64 mm± 0.46 mm (mesial) and 0.68 mm± 0.41 mm (distal) mm. These results showed no statistical difference in mesial and distal sites (P>0.05). Patients indicated a high degree of satisfaction with the full-arch prostheses supported by anterior and pterygoid implants.

Conclusion

For the edentulous maxilla with posterior atrophy, full-arch fixed prostheses supported by anterior and pterygoid implants has an acceptable short-term clinical outcome and excellent patient satisfaction. It may be considered as a predictable and feasible method for maxillary rehabilitation.

Key words: pterygoid implant, pterygomaxillary region, edentulous maxilla, marginal bone loss

中图分类号:

R 783.4

吴瑾, 刘堃, 李明, 朱志军, 汤春波. 翼上颌区种植体联合前部种植体修复萎缩上颌无牙颌的临床回顾研究[J]. 华西口腔医学杂志, 2021, 39(3): 286-292.

Wu Jin, Liu Kun, Li Ming, Zhu Zhijun, Tang Chunbo. Clinical assessment of pterygoid and anterior implants in the atrophic edentulous maxilla: a retrospective study[J]. West China Journal of Stomatology, 2021, 39(3): 286-292.

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植入的设计方案	例数	设计原因及存留情况
4颗前部+2颗翼上颌区种植体	18	最常见的设计，即“All-on-6”。其中，1例患者的1颗翼上颌区种植体在永久修复前失败
5颗前部+2颗翼上颌区种植体	1	患者咬合力较大且对颌为7-7全牙弓种植固定修复，植入更多的前部种植体以保持稳固
6颗前部+2颗翼上颌区种植体	2	患者咬合力较大且对颌为7-7全牙弓种植固定修复，植入更多的前部种植体以保持稳固。其中，1例患者在第一次手术后，由于未能自觉控制吸烟行为，且口腔卫生维护不佳，6颗前部种植体中有4颗失败。对患者进行健康宣教并强制戒烟，3个月后重新补种5颗前部种植体
4颗前部+1颗翼上颌区种植体	2	手术时保留了一侧的上颌第二磨牙，为确定临时修复体的颌位关系提供参考，后期永久修复时拔除
5颗前部+1颗翼上颌区种植体	1	一侧的上颌骨后部骨量充足，植入常规种植体而非翼上颌区种植体
6颗前部+1颗翼上颌区种植体	1	一侧的上颌骨后部骨量充足，植入常规种植体而非翼上颌区种植体

参数	前部种植体（n=113）	翼上颌区种植体（n=46）	P值
PD/mm	2.18±0.44	2.30±0.54	0.191
mSBI	0.07±0.29	0.13±0.40	0.321
PLI	0.99±0.56	1.16±0.76	0.332
MBL/mm
近中	0.62±0.44	0.64±0.46	0.986
远中	0.61±0.40	0.68±0.41	0.961

[1]	张启航, 龚佳明, 余佳颖, 赵瑞敏, 苟萍, 余占海. 在后牙区应用4 mm超短种植体临床效果的Meta分析[J]. 华西口腔医学杂志, 2023, 41(1): 80-87.
[2]	刘建彰. 改良唇-牙-牙槽嵴上颌全口种植义齿分类设计[J]. 华西口腔医学杂志, 2018, 36(3): 233-239.
[3]	黄冉冉孙旭尚针针张黎星. 下颌后牙区软组织水平种植体边缘骨吸收相关因素的临床研究[J]. 华西口腔医学杂志, 2016, 34(2): 145-149.

翼上颌区种植体联合前部种植体修复萎缩上颌无牙颌的临床回顾研究

Clinical assessment of pterygoid and anterior implants in the atrophic edentulous maxilla: a retrospective study

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OHIP-14问卷	术前					随访1年
OHIP-14问卷	从不	偶尔	有时	经常	很经常	从不	偶尔	有时	经常	很经常
1.是否曾因为牙齿或口腔的问题而影响发音？	60	4	24	12	0	40	36	24	0	0
2.是否曾因为牙齿或口腔的问题而感到味觉变差？	60	4	28	8	0	88	12	0	0	0
3.口腔内是否曾出现过明显疼痛？	28	20	20	20	12	72	16	12	0	0
4.是否曾因为牙齿或口腔的问题而觉得吃什么东西都不舒服？	8	4	16	52	20	56	24	16	4	0
5.是否曾因为牙齿或口腔的问题而在其他人面前觉得不自在？	20	4	28	40	8	84	12	4	0	0
6.是否曾因为牙齿或口腔的问题而感到紧张不安？	44	8	24	24	0	96	4	0	0	0
7.是否曾因为牙齿或口腔的问题而对饮食很不满意？	12	8	8	40	32	76	16	8	0	0
8.是否曾因为牙齿或口腔的问题而不得不在进餐时中途停下来？	24	4	44	24	4	84	12	4	0	0
9.是否曾因为牙齿或口腔的问题而不能很好的休息？	60	16	20	4	0	100	0	0	0	0
10.是否曾因为牙齿或口腔的问题而有过尴尬的时候？	24	12	28	20	16	92	0	8	0	0
11.是否曾因为牙齿或口腔的问题而变得容易对其他人发脾气？	100	0	0	0	0	100	0	0	0	0
12.是否曾因为牙齿或口腔的问题而难以完成日常的工作？	84	12	4	0	0	100	0	0	0	0
13.是否曾因为牙齿或口腔的问题而觉得生活不是那么令人满意？	12	8	40	36	4	96	4	0	0	0
14.是否曾因为牙齿或口腔的问题而觉得生活不是那么令人满意？	84	16	0	0	0	100	0	0	0	0