口腔疾病防治 ›› 2022, Vol. 30 ›› Issue (7): 511-516.DOI: 10.12016/j.issn.2096-1456.2022.07.008

• 综述 • 上一篇    下一篇

无牙颌种植固定义齿设计的研究进展

刘诗瑶1(), 晏奇2, 施斌2,*()   

  1. 1.南方医科大学南方医院,南方医科大学口腔医学院,广东 广州(510515)
    2.武汉大学口腔医院种植科,湖北 武汉(430079)
  • 收稿日期:2021-09-26 修回日期:2021-11-28 出版日期:2022-07-20 发布日期:2022-04-25
  • 通讯作者: 施斌
  • 作者简介:刘诗瑶,主治医师,硕士,Email: crystalliudentist@163.com
  • 基金资助:
    国家自然科学基金项目(81901045)

Research progress on the design of fixed implant-supported prostheses in edentulous jaws

LIU Shiyao1(), YAN Qi2, SHI Bin2,*()   

  1. 1. Nanfang Hospital, Southern Medical University &Stomatological College of Southern Medical University, Guangzhou 510515, China
    2. Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
  • Received:2021-09-26 Revised:2021-11-28 Online:2022-07-20 Published:2022-04-25
  • Contact: SHI Bin
  • Supported by:
    Natural Science Foundation of China(81901045)

摘要:

随着人口老龄化和无牙颌患者数量的增加,种植支持式固定义齿修复在临床上的应用越来越多。正确评估患者的剩余骨量和咬合状态十分重要。上颌通常需要6~8颗种植体,而下颌需要4~6颗种植体以完成种植固定修复,而对于牙槽骨萎缩严重的患者,可以采取“All-on-4/6”的治疗方案、短种植体、穿颧穿翼种植体等以避免复杂的植骨手术,以上外科经验要求较高的术式需要谨慎尝试。上部结构按修复方式可以分为整体式修复和分段式修复,整体式修复种植体植入数目少、位置灵活、应力分布合理但后期维护成本大;分段式修复易获得被动就位,方便清洁和后期的维护,但种植体需要数量多,对牙槽骨要求高。咬合设计推荐使用相互保护,尤其在即刻负重时应尽量避免悬臂设计。

关键词: 种植固定修复, 无牙颌, 全牙弓, 修复设计, 咬合, 外科设计, 数字化种植, 翼上颌区种植, 穿颧骨种植, 倾斜种植体

Abstract:

With the aging of the population and the increase in the number of edentulous patients, implant-supported fixed restorations have become more prevalent in clinical treatment. It is necessary to assess the patient's remaining bone and occlusal situation correctly; the upper jaw usually needs 6 to 8 implants, whereas the lower jaw needs 4 to 6 implants. Patients with severe alveolar bone atrophy can adopt the "all-on-4/6" treatment plan, short implants, and zygomatic and pterygomaxillary implants to avoid complex bone grafting and remain cautious when the surgical procedures require more surgical experience. According to the repair methods, the superstructure can be divided into one-piece repair and segmental repair. One-piece repair has a lower implant number, flexible location, and reasonable stress distribution but a high maintenance cost. Sectional repair easily achieves passive placement, convenient cleaning, and maintenance in the late stages, but implants need quantity and high requirements for alveolar bone. However, the requirements for alveolar bone and implant number are high. Mutually protected occlusion with minimal or no cantilever on provisional prosthesis is recommended.

Key words: fixed implant-supported rehabilitations, edentulous jaw, full-arch, prosthesis design, occlusaion consideration, surgical design, computer-assisted implantology, pterygomaxillary implant, zygoma implant, tilted implant

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