Luo J, Zhang Y, Cui H Y, Zhu N, Shen H D, DI P, Lin Y
Department of Implantology, Peking University School and Hospital 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, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Oct 18;52(5):964-970. doi: 10.19723/j.issn.1671-167X.2020.05.029.
To evaluate the digital workflow coupling conic retention for the immediate restoration of adjacent posterior implants.
The patients with adjacent teeth missing in the posterior jaw seeking for implant restoration in the Department of Implantology, Peking University School and Hospital of Stomatology from March, 2017 to February, 2018 were recruited. After implant placement and commercial conic retention coping delivery, the patient had an intraoral scan for digital impression, and the computer-assisted design/computer-assisted manufacturing (CAD/CAM) technology was used for the fabrication of the immediate splinted prosthesis, which was made of polymethyl methacrylate (PMMA) and loaded immediately after delivery. Six months later, all the temporary prostheses were replaced by the permanent ones made of monolithic zirconia with CAD/CAM technology as well. The parallel periapical films were taken for the temporary and permanent prostheses post-delivery. The clinical effect of this workflow was evaluated by indices including the survival rates of implants and prostheses, the change of marginal bone level, and the implant-related and prosthesis-related complications; before the final restoration, the Visual Analogue Score (VAS) was used to evaluate the satisfaction of the patients.
Ten patients (4 males and 6 females, 55.5 years old for average) were recruited. Totally 34 implants were placed; 14 prostheses were fabricated, temporary and permanent, respectively. After an observation period from 4 to 14 months, the survival rate for implants and prostheses were both 100%; the marginal bone level of the implants were (1.06±0.97) mm and (0.96±0.82) mm, immediate post-operation and 6 months later, respectively. The difference was not statistically significant (>0.05). Neither implant- nor prostheses- related complications were observed. And the VAS of the patients' satisfaction was 87.2.
For the adjacent posterior implants, the immediate prostheses manufactured by digital workflow, coupling conic retention, were clinically feasible and patient-satisfactory.
评估数字工作流程结合圆锥固位用于相邻后牙种植体即刻修复的效果。
选取2017年3月至2018年2月在北京大学口腔医院种植科寻求种植修复的后牙区相邻牙缺失患者。种植体植入并交付商用圆锥固位帽后,患者进行口内扫描获取数字印模,采用计算机辅助设计/计算机辅助制造(CAD/CAM)技术制作即刻联冠式修复体,该修复体由聚甲基丙烯酸甲酯(PMMA)制成,交付后即刻戴入。6个月后,所有临时修复体同样采用CAD/CAM技术更换为全锆单冠永久修复体。分别在临时和永久修复体戴入后拍摄平行根尖片。通过种植体和修复体的存留率、边缘骨水平变化以及种植体和修复体相关并发症等指标评估该工作流程的临床效果;在最终修复前,采用视觉模拟评分(VAS)评估患者满意度。
共纳入10例患者(男性4例,女性6例,平均年龄55.5岁)。共植入34枚种植体;分别制作了14个临时和永久修复体。经过4至14个月的观察期,种植体和修复体的存留率均为100%;种植体术后即刻及6个月后的边缘骨水平分别为(1.06±0.97)mm和(0.96±0.82)mm。差异无统计学意义(>0.05)。未观察到种植体及修复体相关并发症。患者满意度的VAS评分为87.2。
对于相邻后牙种植体,采用数字工作流程结合圆锥固位制作的即刻修复体在临床上可行且患者满意度高。