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目的:评价种植体不同固位方式在种植体-天然牙联合支持的覆盖义齿修复中的临床应用效果。方法:选择9例下颌剩余1～2颗基牙的牙列缺损病例,在完善根管治疗和牙周治疗后,于下颌后牙区与剩余基牙尽量分散间隔种植2颗BEGO系统种植体。3个月后,9例病例随机分三组,分别设计成种植体支持的球帽固位、locator固位、磁性附着体固位的覆盖义齿修复,所有患者下颌天然牙截冠后设计根上太极扣固位,记录患者修复完成3年后的主观感觉及义齿使用情况,同时记录修复前、修复后6个月、修复后1年和修复后3年的三组余留牙和种植体的临床牙周指标:牙龈指数(gingival index,GI),探诊深度(probing depth,PD),松动度情况。结果:修复完成后3年18颗种植体无临床松动;9例种植覆盖义齿均可正常使用,7例患者对外貌及义齿的使用和语音功能满意,1例磁性附着体固位患者基本满意,1磁性附着体固位的患者对覆盖义齿固位不满意。球帽和磁性附着体固位的种植体GI在修复后6个月、1年、3年和修复前相比差异无统计学意义(P>0.05)。locator固位种植的GI在修复后6个月和修复前相比差异有统计学意义(P<0.01)。3种固位方式种植体的PD在修复后6个月、1年、3年和修复前相比均无显著性差异(P>0.05)。其中种植体支持的磁性固位病例余留牙的GI和PD在修复后3年和修复前相比均有显著性差异(P<0.01)。结论:对于预留牙很少的牙列缺损的患者,种植体球帽和locator固位联合预留牙根帽支持的覆盖义齿是一种可行、有效的修复方法。但是磁性附着体因固位方式和缓冲空间和根上太极扣不能完全一致,联合使用不利余留牙和覆盖义齿的稳定使用。
OBJECTIVE: To evaluate the clinical effect of different implant fixation methods in the overdenture restoration supported by implant-natural teeth. Methods: Nine cases of dentition defect of the remaining 1 or 2 abutments of the mandible were selected. After complete root canal treatment and periodontal treatment, 2 BEGO system implants were placed in the mandibular posterior area and the remaining abutment as much as possible. Three months later, nine patients were randomly divided into three groups, respectively, designed to support the implant-cap retention, locator retention, magnetic attachment retention overdenture repair, all patients with mandibular natural teeth after the crown design root Tai Chi The position and the denture usage were recorded 3 years after the patient was repaired, and the clinical periodontal records of three groups of remaining teeth and implants before repair, 6 months after repair, 1 year after repair, and 3 years after repair Indicators: gingival index (GI), probing depth (PD), degree of loosening. Results: There was no clinical loosening of 18 implants in 3 years after the repair was completed. All the 9 cases were covered with overdentures. All the 7 cases were satisfied with the appearance and denture usage and voice function. One case with magnetic attachment retention was basically satisfactory, Patients with magnetic attachment retention are not satisfied with overdenture retention. There was no significant difference in the GI of implants with ball cap and magnetic attachment after 6 months, 1 year, 3 years and before repair (P> 0.05). Locator immobilized GI showed a significant difference (P <0.01) at 6 months after repair compared with that before repair. There was no significant difference (P> 0.05) between the PD of 3 kinds of retention implants at 6 months, 1 year, 3 years and before repair. There was a significant difference in the GI and PD of residual teeth in the magnetic retention cases supported by implants at 3 years after repair and before repair (P <0.01). CONCLUSIONS: Implant ball caps and locator retention in combination with reserved root caps for overdentures are a feasible and effective method for repairing dentition defects with few reserved teeth. However, the magnetic attachment due to the retention mode and the buffer space and root Tai Chi can not be exactly the same, combined use of residual teeth and overdenture denture stable use.