發(fā)布時間：2018-04-05 02:34

  本文選題：無牙頜　切入點：all-on-four　出處：《青島大學(xué)》2017年碩士論文

【摘要】：目的:臨床研究all-on-four無牙頜固定義齒的種植及修復(fù)的方法以及與植入相同種植體顆數(shù)的種植覆蓋義齒相對比,觀察種植體及上部修復(fù)體成功率、種植體牙周健康(包括種植體周圍菌斑指數(shù)及探針出血指數(shù))、咀嚼效率測定、患者滿意度調(diào)查及種植體周圍骨高度變化6個方面。方法:臨床收集無牙頜患者,制作普通全口義齒,如固位力、穩(wěn)定性等不能滿足患者需求,則按照all-on-four術(shù)式制作種植固定義齒修復(fù)或進行4顆種植支持覆蓋義齒修復(fù)。將all-on-four固定修復(fù)患者設(shè)為A組,植入4顆種植體行覆蓋義齒修復(fù)患者設(shè)為B組。兩組分別按照如下方法進行研究:術(shù)前設(shè)計及制作CAD/CAM導(dǎo)板,在數(shù)字化導(dǎo)板的引導(dǎo)下A、B兩組分別進行種植手術(shù)。A組按照all-on-four術(shù)式將4顆種植體植入患者頜骨內(nèi),24h內(nèi)為患者制作種植體支持式臨時義齒,經(jīng)過3-6月的骨結(jié)合后行永久修復(fù)。B組在導(dǎo)板的定位下將4顆種植體植入患者頜骨內(nèi),經(jīng)過3-6月的骨結(jié)合,制作種植體支持式覆蓋義齒。對上述A、B兩組患者進行臨床觀察:永久修復(fù)1個月后對兩組患者分別進行滿意度調(diào)查。永久修復(fù)12個月后對兩組患者分別進行種植體及修復(fù)體成功率、種植體牙周健康(包括種植體周圍菌斑指數(shù)及探針出血指數(shù))、咀嚼效率測定及種植體周圍骨高度變化的檢測。結(jié)果:1.按照all-on-four術(shù)式在患者前牙區(qū)植入2顆軸向種植體,遠中植入2顆傾斜種植體,利用4顆種植體支持的單頜螺絲固位一段式固定橋。只需要種植4顆種植體即可實現(xiàn)無牙頜固定修復(fù),減輕患者的手術(shù)創(chuàng)傷及費用。在種植手術(shù)當天患者即可戴入種植體支持式臨時義齒,解決了種植體愈合期內(nèi)患者無牙的情況。提高了患者的生活質(zhì)量。2.永久修復(fù)1個月后,對患者進行義齒滿意度問卷調(diào)查,問卷調(diào)查顯示,與植入相同數(shù)目種植體的種植覆蓋義齒相比,all-on-four無牙頜種植固定修復(fù)在咀嚼、舒適、方便及發(fā)音方面得分高于種植覆蓋義齒,差異有統(tǒng)計學(xué)意義(P0.05)。3.永久修復(fù)12個月后,對兩組患者進行種植體及修復(fù)體成功率、種植體牙周健康(包括種植體周圍菌斑指數(shù)及探針出血指數(shù))、咀嚼效率測定及種植體周圍骨高度變化的監(jiān)測,結(jié)果A、B兩組在種植體及修復(fù)體成功率、種植體牙周健康、種植體周圍骨高度變化方面A、B兩組差異無統(tǒng)計學(xué)意義(P0.05),對A、B兩組進行咀嚼效率測定結(jié)果顯示A組高于B組,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.All-on-four無牙頜種植修復(fù)技術(shù)只需植入4顆種植體即可實現(xiàn)無牙頜固定修復(fù)。2.All-on-four無牙頜種植修復(fù)技術(shù)與種植體支持式覆蓋義齒修復(fù)相比,得到較高的咀嚼效率和患者滿意度。3.All-on-four無牙頜種植修復(fù)技術(shù)與種植體支持式覆蓋義齒修復(fù)相比,在種植體及其上部修復(fù)體成功率、種植體牙周健康(包括種植體周圍菌斑指數(shù)及探診出血指數(shù))及種植體周圍骨高度變化方面差異無統(tǒng)計學(xué)意義。
[Abstract]:Objective: to investigate the methods of implant and repair of all-on-four denture and compare with the same number of implants to observe the success rate of implants and upper implants.Implant periodontal health (including plaque index and probe bleeding index), masticatory efficiency measurement, patient satisfaction survey and bone height changes around the implant.Methods: the patients with edentulous jaws were collected clinically, and general complete dentures were made. If the retention and stability could not meet the needs of the patients, the implant fixed dentures or 4 implant-supported overdentures were made according to the all-on-four procedure.Group A was fixed with all-on-four and group B was implanted with 4 implants for overdenture.The two groups were studied according to the following methods: preoperative design and fabrication of CAD/CAM guide plate,Under the guidance of digital guide plate, group A and group A were respectively treated with implant operation. Group A made implant-supported temporary dentures for patients within 24 hours according to all-on-four procedure.Four implants were implanted into the jaws of the patients after 3 to 6 months of bone bonding. The implant-supported overdentures were made in group B under the guidance of the guide plate.The clinical observation was carried out in the above two groups: one month after permanent repair, the satisfaction of the two groups were investigated.After 12 months of permanent restoration, implant and prosthesis success rate, periodontal health (including plaque index and probe bleeding index), masticatory efficiency and bone height around implant were measured.The result is 1: 1.According to all-on-four procedure, two axial implants and two oblique implants were implanted in the anterior teeth of the patients, and 4 implants supported by single jaw screws were used to maintain a fixed bridge.Only 4 implants can be used to repair edentulous jaw and reduce the surgical trauma and cost.Implant-supported temporary dentures can be worn on the day of implant implantation, which solves the problem of dental absence during the healing period of implants.Improved the patient's quality of life.A month after permanent restoration, a questionnaire survey on denture satisfaction showed that the all-on-four dental prosthesis was chewed and comfortable compared with the implant overdenture with the same number of implants.The scores of convenience and pronunciation were higher than that of implant overdenture, and the difference was statistically significant (P 0.05).After 12 months of permanent restoration, implant and prosthesis success rate, periodontal health (including plaque index and probe bleeding index), masticatory efficiency and bone height around implant were measured.Results there was no significant difference in the success rate of implant and prosthesis, the periodontal health of implant and the change of bone height around implant between two groups (P 0.05). The masticatory efficiency of group A was higher than that of group B (P 0.05), and the masticatory efficiency of group A was higher than that of group B.The difference was statistically significant (P 0.05).Conclusion: 1. All-on-four dental prosthesis can be implemented with only 4 implants. 2. All-on-four dental prosthesis is compared with implant-supported overdenture.Higher masticatory efficiency and patient satisfaction. 3. All-on-four dental prosthesis technology compared with implant-supported overdenture, the success rate of implants and their upper implants,There was no significant difference in periodontal health (including plaque index and bleeding index) and bone height around implant.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R783.6

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