中国药物与临床
中國藥物與臨床
중국약물여림상
CHINESE REMEDIES & CLINICS
2014年
12期
1629-1632
,共4页
郑强%陈凰%朱卉%翟红芳%范志芳%郑好
鄭彊%陳凰%硃卉%翟紅芳%範誌芳%鄭好
정강%진황%주훼%적홍방%범지방%정호
牙种植,骨内%牙修复体固位%手术外科,微创性
牙種植,骨內%牙脩複體固位%手術外科,微創性
아충식,골내%아수복체고위%수술외과,미창성
Dental implantation,endosseous%Dental prosthesis retewtion%Surgical procedures,minimally invasive
目的：通过完成1例无牙颌患者的微创式全口种植牙手术并椅旁行螺丝固位托牙式全口固定义齿即刻修复即刻负重病例，探讨老年无牙颌患者的全口牙种植手术、修复技术的临床操作技术要点。方法选取1例无牙颌女性老年患者，术前进行影像学检查和模型设计，制作外科手术导板，使用不翻瓣微创种植手术，一次在其上颌骨和下颌骨共植入16个骨水平种植体，即刻安装螺丝固位托牙式全口固定义齿并即刻负重。结果手术导板精确引导医生完成一期种植手术；微创种植手术创伤小，手术出血量少；手术时间明显缩短；患者未出现明显的术后疼痛肿胀；种植牙的托牙式全口固定义齿即刻修复后固位良好，并能即刻负重，马上恢复口腔功能，患者极为满意；术后8个月追踪，全部种植体均为良好骨结合，种植体不松动，全景片上种植体周围未见有明显的骨吸收；义齿功能良好，稳定舒适。结论利用手术导板精确地引导种植手术，微创种植手术的创伤明显小于常规翻瓣种植手术的创伤，手术部位术后无感染、无肿胀；微创种植的手术时间大大缩短；种植体骨结合好，经过8个月追踪，未发现有明显的种植体周围骨吸收；即刻修复可以减少患者常规种植后要等待3个月以上的愈合期；即刻负重技术可以马上恢复患者的口腔功能；螺丝固位托牙式全口固定种植义齿有良好的功能，又便于拆卸修理；全口种植托牙式义齿可以充分修复患者的口腔组织缺损，恢复正常面容效果良好，并且树脂托牙义齿制做便捷，价格便宜，适用广泛；单颌牙列缺失者种植6~8个人工牙根，在数量上可以达到充分承担咬合力和分散咬合力的生物力学要求，并能承担个别种植体失败的补偿；种植修复托牙式全口义齿将全部种植体通过基托进行整体联合连接，可以充分承担和分散咬合力量，并将咬合力量直接通过种植体传导于牙槽骨内部，对牙槽骨产生生理性刺激，中止牙槽骨的持续性吸收萎缩，并促进牙槽骨的骨质再生，保持牙槽骨的丰满。
目的：通過完成1例無牙頜患者的微創式全口種植牙手術併椅徬行螺絲固位託牙式全口固定義齒即刻脩複即刻負重病例，探討老年無牙頜患者的全口牙種植手術、脩複技術的臨床操作技術要點。方法選取1例無牙頜女性老年患者，術前進行影像學檢查和模型設計，製作外科手術導闆，使用不翻瓣微創種植手術，一次在其上頜骨和下頜骨共植入16箇骨水平種植體，即刻安裝螺絲固位託牙式全口固定義齒併即刻負重。結果手術導闆精確引導醫生完成一期種植手術；微創種植手術創傷小，手術齣血量少；手術時間明顯縮短；患者未齣現明顯的術後疼痛腫脹；種植牙的託牙式全口固定義齒即刻脩複後固位良好，併能即刻負重，馬上恢複口腔功能，患者極為滿意；術後8箇月追蹤，全部種植體均為良好骨結閤，種植體不鬆動，全景片上種植體週圍未見有明顯的骨吸收；義齒功能良好，穩定舒適。結論利用手術導闆精確地引導種植手術，微創種植手術的創傷明顯小于常規翻瓣種植手術的創傷，手術部位術後無感染、無腫脹；微創種植的手術時間大大縮短；種植體骨結閤好，經過8箇月追蹤，未髮現有明顯的種植體週圍骨吸收；即刻脩複可以減少患者常規種植後要等待3箇月以上的愈閤期；即刻負重技術可以馬上恢複患者的口腔功能；螺絲固位託牙式全口固定種植義齒有良好的功能，又便于拆卸脩理；全口種植託牙式義齒可以充分脩複患者的口腔組織缺損，恢複正常麵容效果良好，併且樹脂託牙義齒製做便捷，價格便宜，適用廣汎；單頜牙列缺失者種植6~8箇人工牙根，在數量上可以達到充分承擔咬閤力和分散咬閤力的生物力學要求，併能承擔箇彆種植體失敗的補償；種植脩複託牙式全口義齒將全部種植體通過基託進行整體聯閤連接，可以充分承擔和分散咬閤力量，併將咬閤力量直接通過種植體傳導于牙槽骨內部，對牙槽骨產生生理性刺激，中止牙槽骨的持續性吸收萎縮，併促進牙槽骨的骨質再生，保持牙槽骨的豐滿。
목적：통과완성1례무아합환자적미창식전구충식아수술병의방행라사고위탁아식전구고정의치즉각수복즉각부중병례，탐토노년무아합환자적전구아충식수술、수복기술적림상조작기술요점。방법선취1례무아합녀성노년환자，술전진행영상학검사화모형설계，제작외과수술도판，사용불번판미창충식수술，일차재기상합골화하합골공식입16개골수평충식체，즉각안장라사고위탁아식전구고정의치병즉각부중。결과수술도판정학인도의생완성일기충식수술；미창충식수술창상소，수술출혈량소；수술시간명현축단；환자미출현명현적술후동통종창；충식아적탁아식전구고정의치즉각수복후고위량호，병능즉각부중，마상회복구강공능，환자겁위만의；술후8개월추종，전부충식체균위량호골결합，충식체불송동，전경편상충식체주위미견유명현적골흡수；의치공능량호，은정서괄。결론이용수술도판정학지인도충식수술，미창충식수술적창상명현소우상규번판충식수술적창상，수술부위술후무감염、무종창；미창충식적수술시간대대축단；충식체골결합호，경과8개월추종，미발현유명현적충식체주위골흡수；즉각수복가이감소환자상규충식후요등대3개월이상적유합기；즉각부중기술가이마상회복환자적구강공능；라사고위탁아식전구고정충식의치유량호적공능，우편우탁사수리；전구충식탁아식의치가이충분수복환자적구강조직결손，회복정상면용효과량호，병차수지탁아의치제주편첩，개격편의，괄용엄범；단합아렬결실자충식6~8개인공아근，재수량상가이체도충분승담교합력화분산교합력적생물역학요구，병능승담개별충식체실패적보상；충식수복탁아식전구의치장전부충식체통과기탁진행정체연합련접，가이충분승담화분산교합역량，병장교합역량직접통과충식체전도우아조골내부，대아조골산생생이성자격，중지아조골적지속성흡수위축，병촉진아조골적골질재생，보지아조골적봉만。
Objective To investigate the know-how in full-mouth dental implantation and restoration for elderly edentulous patients througha completed case of minimally invasive full mouth dental implantation with screw retention of complete denture for immediateloadafterimmediate restoration technology. Methods An edentulous elderly female patient was selected for the treatment, with preoperative imaging and model design.Surgical operation template was preparedfor flapless minimally invasive dental implantation. A total of 16 dental implants were placed one-stage in her maxilla and mandible. And screw retention was fixed immediately for the complete denture with immediate load. Re-sults Surgical operation template guided the doctors precisely to complete one-stage implantation. Minimally invasive implantationresulted in little trauma and bleeding. The operation time was shortened significantly. The patient did not suffer significant postoperative pain and swelling. The dental implant was highly satisfactory for the patient, and was able to load and recover oral function immediately after good retention of complete dental implant. After 8 months of postoperative follow-up, all the implants showed excellent bone union without any loosening. And the panoramic radio-graph showed no significant bone resorption around the implants. The denture function was good, stable and comfort-able. Conclusion Using precise surgical operation template guided implant surgery, minimally invasive implant oper-ationmay result in less trauma than conventional flap implantation without infections and swelling on surgical sites. As the time of minimally invasive operation was shortened greatly, the stamina of both patients and doctors were saved up. The implants had excellent bone union, and no significant bone resorption around the implants was found after 8 months of follow-up. Immediate restoration can reduce more than 3 months of healing phase after conventional im-plantation surgery. Immediate loading technique can recover the patients′ oral function immediately, helping them to achieve the wish of"gaining teeth immediately after dental implant operation". Screw retention of complete denture for dental implant provides good functions, and the convenience for removal and restoration. Complete implant denture can fully repair patients' oral tissue defects, which had good effects to recover their normal facial features. Besides, resin denture is easy to produce at low costs and for wide application. The 6 to 8 artificial teeth roots implantation for single edentulous patients can fully meet biomechanical requirement of bearing and dispersing bite force, and assume the failure of individual implants. Implanting and repairing complete denture can connect all the implants entirely by basic denture, and fully bear and disperse bite force, so as to conduct bite force into the inside of alveolar bone by implants. With physiological stimulation to alveolar bone, it can stop persistent atrophicabsorption, stimulate regenera-tion, and maintain the fullness of the alveolar bone.
