高锦瑜　张文娟

[摘 要] 目的：评价种植体与天然牙联合固定修复效果，为牙列缺失治疗方案的选择提供参考。方法：以我院2011年1月—2012年1月收治的60例牙列缺失患者为研究对象，按照随机数字表分为观察组及对照组，各30例，分别应用种植体与天然牙联合固定修复及单纯种植体修复治疗，于治疗3年后评价两组患者修复效果、满意度及骨吸收情况。结果：观察组30例患者53枚种植体脱落4颗，修复成功率92.5%，对照组30例患者55枚修复体脱落2颗，修复成功率96.4%，两组种植体修复成功率比较，差异无统计学意义（P>0.05），随访期间均未见种植体断裂或明显松动。观察组患者疼痛、创伤度满意度均显著高于对照组，差异有统计学意义（P<0.05）。两组患者术区牙槽骨吸收量均逐渐增加，观察组术后18个月牙槽嵴骨吸收量显著高于对照组，差异有统计学意义（P<0.05）。观察组患者术后种植体舌侧骨吸收量亦逐渐上升（P<0.05），但均在1.5 mm以内。结论：种植体与天然牙联合固定修复牙列缺失可取得良好的短期效果，患者满意度较高，但该方案在一定程度上会造成术区骨吸收量增加，其长远修复效果有待进一步观察。

[关键词] 种植体；天然牙；牙列缺失；固定修复

中图分类号：R783.5 文献标识码：B 文章编号：2095-5200（2016）05-050-04

[Abstract] Objective： To evaluate the effect of the combination implant-to-natural-tooth for fixed restoration， hopefully providing a reference for the selection of treatment options for tooth loss. Methods： 60 patients with dentition defects in our hospital from January 2011 to January 2012 were selected as the research object. They were randomly divided into observation group and control group， with 30 cases in each group， and were used the combination implant-to-natural-tooth for fixed restoration and single-implant treatment， respectively. Repairing effect， the satisfaction and bone resorption were compared between the two groups of patients after 3 years for treatment. Results： 4 teeth loss in a total of 53 implants among 30 patients in the observation group， the successful rate was 92.5%， 2 cases loss in a total of 55 tooth-restoration among 30 patients in the control group， the successful rate was 96.4%， implant success rates of two groups were compared， the difference was not statistically significant （P>0.05）. No implant fracture or obviously loose during the follow-up period. In the observation group， the patients pain and trauma satisfaction were both significantly higher than those in the control group； the difference were statistically significant （P<0.05）. The amount of alveolar bone absorption in the two groups was gradually increased， and the absorption of alveolar bone was significantly higher than that of the control group after 18 months for treatment， the difference was statistically significant （P<0.05）. In the observation group， the amount of bone resorption of lingual alveolar bone was also increased gradually （P<0.05）， but no more than 1.5 mm. Conclusions： The combination implant-to-natural-tooth for fixed restoration of dentition defects can obtain good short-term effect with high patient satisfaction， but it will cause the increasing of postoperative bone resorption to a certain extent， its long-term repair effect needs further observation.

[Key words] implant； natural teeth； dentition defect； fixed restoration

牙列缺失多由牙周病或外伤引发，多伴有牙槽骨严重吸收或骨缺损、邻牙牙体牙髓或牙周病变及基牙分布不均，对患者的美观度、言语及咀嚼功能均存在明显影响[1]。固定桥和可摘局部义齿是修复牙列缺失的传统方案，前者易造成基牙继发龋等损伤，安全性不够理想，后者稳定性、舒适性、美观性及咀嚼效率均无法满足患者要求[2]。近年来，种植义齿以其体积小、稳定性高、固位力强等优势受到了广泛关注，鉴于牙列缺失间隙、位置及种植区骨质条件的影响，在临床实际工作中，常采取种植体与天然牙联合固定修复方案。但有学者指出，种植体与牙槽骨为骨性结合，而天然牙与牙槽骨之间由牙周膜相连，二者生物力学特征各不相同，联合固定修复易引发应力分布不均、骨吸收等不良后果，影响固定修复的效果[3]。为明……