刘静雅　何 军　宋小顺　高永红　王振宇　李学智

[關键词]改良粘接固位;种植义齿修复;骨吸收;改良出血指数;改良菌斑指数

[中图分类号]R783.6    [文献标志码]A    [文章编号]1008-6455（2021）12-0132-03

Effect of Modified Implantable Denture on Bone Resorption around Implant after Implant Denture Repair

LIU Jing-ya，HE Jun， SONG Xiao-shun， GAO Yong-hong， WANG Zhen-yu， LI Xue-zhi

（Department of Stomatology， the First People's Hospital of Xining City，Xining 810000，Qinghai，China）

Abstract： Objective  To investigate the effect of modified implantable denture after implant denture repair on bone resorption around the implant. Methods  Between January 2014 and January 2019， 300 patients with dental defects undergoing implant denture repair in the department of stomatology of our hospital were selected as the research subjects. They were divided into the research group and the control group by random number table method， with 150 cases in each group. The control group received direct adhesive therapy， while the research group received modified implantable denture therapy. The two groups were followed up for 12 months after surgery. The satisfaction， bone resorption around implants， improved bleeding index （mSBI）  classification and improved plaque index （mPLI） classification at 12 months after surgery were compared between the two groups. Results  12 months after surgery， satisfaction scores on the comfort degree， chewing function， language function， retention function and aesthetic function of implantable denture repair in the research group were higher than those of the control group （P<0.05）. 12 months after surgery， the height and thickness of alveolar bone on the lip side and tongue side in the research group were higher than those of the control group （P<0.05）. 12 months after surgery， the amount of distal and proximal bone uptake in the research group was lower than that in the control group （P<0.05）. 12 months after surgery， proportions of grade 0 of mSBI grading and mPLI grading in the research group were higher than those in the control group， and proportions of grade 2 were lower than those in the control group （44.00% vs 32.00%， 30.00% vs 41.33%， 20.67% vs 11.33%， 16.67% vs 26.67%， P<0.05）. Conclusion  Modified implantable denture after implant denture repair could inhibit the bone resorption around the implant， improve the health of periodontal tissue， and improve the patient satisfaction.

Key words： modified implantable denture; implant denture repair; bone resorption; improved bleeding index; improved plaque index

种植义齿修复为牙列缺损患者首选治疗方案，无需磨削邻牙即可进行牙齿固定，近年来，随着经济发展和人民健康意识的提高，人们越来越重视口腔健康及美观程度，牙列缺损尤其是后牙缺损的临床治疗率也在提高[1]。直接粘接固位是种植义齿修复的常用固定方案，应用时间长，且研究显示[2]，其相较螺丝固位具有美观、操作简便，更容易获得牙冠的被动就位等优势，但仍存在牙冠被动升高、粘接剂残留等缺陷。近年来，随着口腔正畸研究的深入，有学者提出[3]，改良粘接固位治疗方案可通过暂封基台中孔，后期进行少量填充封闭来提高粘接效果，但目前改良粘接固位在种植义齿修复的临床应用时间较短，临床效果及机制尚需进一步探究。基于此，本研究对比改良粘接固位与直接粘接固位后种植义齿修复对种植体周围骨吸收的影响，旨在为种植义齿修复治疗方案的改良提供新的依据，现报道如下。

1  资料和方法

1.1 一般资料：选择2014年1月-2019年1月笔者医院口腔科收治的300例行种植义齿修复的牙齿缺陷患者为研究对象，经医院医学伦理委员会审核通过后，以随机数字表法将其分为研究组和对照组，每组150例。研究组：男77例，女73例，年龄19～64岁，平均（45.53±6.79）岁;体质量指数（BMI）18～24 kg/m2，平均（21.32±0.69）kg/m2;对照组：男79例，女71例，年龄18～61岁，平均（44.55±6.21）岁;BMI 19～24kg/m2，平均（21.13±0.75）kg/m2。……