中国实用口腔科杂志 ›› 2026, Vol. 19 ›› Issue (1): 99-105.DOI: 10.19538/j.kq.2026.01.016

• 综述 • 上一篇    下一篇

减少种植修复粘接固位残留粘接剂的方法研究进展

刘雨萱1,宋宏杰2   

  1. 1. 川北医学院口腔医学院,四川 南充 637000;2. 成都市第二人民医院口腔科,四川 成都 610000
  • 出版日期:2026-01-30 发布日期:2026-01-30
  • 通讯作者: 宋宏杰

  • Online:2026-01-30 Published:2026-01-30

摘要: 粘接固位在口腔修复中具有诸多优点,如良好的美学效果、易获得被动就位、对种植体的多角度适应性及较低的制作成本等,但存在残留粘接剂(residual excess cement,REC)问题。REC易使细菌积聚形成生物膜,刺激软硬组织,同时释放单体加重炎症,引发骨质吸收,影响种植体的稳定性与寿命。文章就减少REC的相关策略做一综述:代型技术尤其是改进的数字化代型可精准调控尺寸、保障边缘密合性与粘接强度,优化修复体和基台设计、改进粘接技术也可降低REC风险;传统去除粘接剂的方法存在局限,而激光和超声配合聚醚醚酮(polyetheretherketone,PEEK)工作尖清除效果良好。目前多数实验基于体外模型,临床转化不足,且缺乏标准化操作流程。未来应开展长期临床随访,评估不同策略实际效果,研发低黏附性粘接剂与抗磨损工具,整合人工智能优化设计,制定标准化指南,以实现“精准控残”,降低种植体周炎风险,改善患者预后。

关键词: 粘接固位, 残留粘接剂, 种植体周围疾病, 种植修复, 牙科粘接剂

Abstract: Cement-retained restorations are widely used in prosthodontics due to their excellent aesthetic effects,ease in obtaining passive seating,multi-angle adaptability to implants,and low fabrication costs. However,a major drawback is the residual excess cement(REC),which can lead to bacterial accumulation,formation of biofilm,stimulation of soft and hard tissues and the release of cytotoxic substances,thus aggravating inflammation and causing peri-implant bone resorption,which ultimately compromises implant stability and longevity. This paper is a review of the strategies to reduce REC:abutment replica,especially improved digital replica that precisely control dimensions and ensure marginal fit and bond strength. Optimizing the design of restorations and abutments,as well as improving cementation techniques,can also lower the risk of REC. Traditional cement removal methods have limitations,and the combination of lasers and ultrasound with polyetheretherketone tips has shown good effectiveness in cement removal. At present,most experiments on REC reduction are based on in-vitro models and are insufficient in clinical translation,and there is also a lack of standardized protocols for cement removal. Future research should focus on long-term clinical follow-up to evaluate the effectiveness of different strategies in real-world conditions. Developing low-adhesion cements and wear-resistant instruments,integrating AI-optimized design,and establishing standardized guidelines are also essential. The ultimate goal is to achieve"precision control of residual cement"to reduce the risk of peri-implantitis and improve patient outcomes.

Key words: cement-retained, residual excess cement, peri-implant disease, implant restorations, dental cements

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