左胜元 徐莹

[摘要]目的：分析在口腔科单牙即刻种植中椅旁数字化即刻修复技术的应用价值。方法：240例（共298颗牙）即刻种植患者根据自愿选择的种植、修复方法不同分为两组。A组：120例（150颗牙），选择椅旁数字化技术辅助设计与制作螺丝固位二硅酸锂修复体；B组：120例（148颗牙），传统加工方法制作螺丝固位树脂临时修复体。分别于修复后6个月、1年复诊时进行修复效果评定和修复满意度评价。结果：两组修复6个月复诊率均为100%，A组固位、边缘适合性、边缘染色、牙龈健康5项指标均达到A、B级，即均在临床可接受范围内，仅6例（4.00%）修复体外形为C级，两组外形、固位、边缘适合性、边缘染色、牙龈健康分级方面比较，差异有统计学意义（P<0.05）。A组、B组1年复诊率分别为93.33%、94.17%，A组边缘适合性、边缘染色、牙龈健康3項指标均仍达到A、B级，即均在临床可接受范围内，仅10例（7.09%）修复体外形、2例（1.42%）固位为C级，两组在修复体外形、固位、边缘适合性、边缘染色分级方面差异有统计学意义（P<0.05）。A组修复后6个月、1年的视觉模拟满意度（VAS）评分均显著高于B组，差异有统计学意义（P<0.05）。结论：椅旁数字化技术应用于单牙即刻种植即刻修复，可在外形、固位、边缘适合性、边缘染色、牙龈健康等方面取得理想的修复效果，患者满意度高。

[关键词]椅旁；数字化技术；单牙；即刻；种植；修复

[中图分类号]R783.3 [文献标志码]A [文章编号]1008-6455（2018）06-0099-04

Abstract： Objective To analyze the application value of immediate digital repair technology in the single dental immediate implant in Department of Stomatology. Methods 240 cases of patients （with a total of 298 teeth） enrolled in implanting section of our Stomatological Hospital from January 2015 to May 2016 were selected for the research and divided into two groups according to the implanting and restorative methods chosen by patients voluntarily. The A group 120 cases， 150 teeth， the design and production of screw-retained bisilicapeli restorations assisted by chairside digital technology） . The B group 120 cases， 148 teeth， the making of screw-fixed temporary resin restorations by the traditional processing method）. Restoration effect evaluation and restoration satisfaction evaluation were carried out in the follow-up visit in the repair after 6 months or 1 year. Results The rates of follow-up visit after 6 months of two groups both were 100%. The four indexes of dummy in the A group， including the retention， edge suitability， edge staining and gum health， attained the level of A and B， that's to say， the four indexes were all within the clinically acceptable range，in only 6 cases （4%）， the shape of the complex was C，therefore there were significantly statistical differences in the five indexes of two groups（P<0.05）. The rates of follow-up visit after 1 year of two groups were 93.33% and 94.17% 95.35% respectively. The three indexes of dummy in the A group still achieve the level of A and B and were all within the clinically acceptable range， in 10 cases （7.09%）， the shape of the prosthesis and 2 cases （1.42%） were C grade，and there were significantly statistical differences in the shape， retention， edge suitability， edge staining（P<0.05）. The visual analogue satisfaction score （VAS） in the A group in the repair after 6 months or 1 year was significantly higher than that in the B group（P<0.05）. Conclusion Chairside digital technology for immediate implantation and immediate restoration of single tooth has an ideal effect for restoration with high patient satisfaction in the aspects of the shape， retention， edge suitability， edge dyeing， gum health.

Key words： chairside； digital technology； single tooth； immediate； implantation； restoration

残根、残冠为临床十分常见的牙体病变，亦为牙体缺损修复的常见类型，若未得到有效的种植修复，不仅影响面部美观，增加拔牙后各类修复的后续治疗费用，而且不利于保持牙槽骨，继而增加修复损伤。临床对于牙体缺损，尤其是大面积缺损的患牙一般采用直接充填、桩冠等方法进行修复，但此类常规充填方法易发生微渗漏、邻接不良、继发龋等不良事件，影响修复效果。尤其是近年来随着患者对种植效果及美学需求的增加，越来越多的医师开始注重缩短患者就诊次数，快速恢复因牙體病变引起的美容、功能及心理方面的问题。随着计算机技术和数字化加工技术在口腔修复领域的广泛应用以及口腔粘接技术的提高，椅旁数字化技术使牙体缺损一次就诊完成修复得以实现，且临床效果显著，患者满意度高[3]。……