中国实用口腔科杂志 ›› 2025, Vol. 18 ›› Issue (4): 418-423.DOI: 10.19538/j.kq.2025.04.005

• 论著 • 上一篇    下一篇

上颌无牙颌种植短牙弓即刻负重临床效果研究

李笑班,李晋蒙,顾    客,王艳颖,张    健   

  1. 天津市口腔医院口腔种植科,南开大学医学院,天津市口腔功能重建重点实验室,天津 300041
  • 出版日期:2025-07-30 发布日期:2025-07-30
  • 通讯作者: 张健
  • 基金资助:
    天津市卫生健康科技项目-重点学科专项(TJWJ2024XK018);天津市卫生健康委员会津门医学英才(TJSJMYXYC-D2-041)

  • Online:2025-07-30 Published:2025-07-30

摘要: 目的    分析在上颌无牙颌种植固定修复中恢复前牙区6 ~ 9颗义齿的短牙弓即刻负重临床效果。方法    收集2020年7月至2022年12月在天津市口腔医院口腔种植科行上颌无牙颌种植短牙弓即刻负重修复的10例患者的临床和影像学资料行回顾性分析。术前设计种植体植入位置、制作导板,双侧上颌窦前壁间植入4颗种植体并即刻修复6 ~ 9颗义齿,远中磨牙区行上颌窦底提升术同期或延期种植体植入,待远中磨牙区种植体骨结合后行整体桥永久修复。分析从即刻修复至永久修复期间种植体存留率、边缘骨吸收量、修复体并发症及有记录的患者报告的不适症状。结果    10例患者前牙区共植入40颗种植体,从即刻修复至永久修复期间佩戴短牙弓临时修复体平均(13.4 ± 4.5)个月,无种植体脱落,种植体存留率为100%;近远中边缘骨吸收量平均为(0.69 ± 0.51)mm,未见大范围边缘骨吸收;发生树脂修复体折断5例,修复体折断时间是在即刻修复后5 ~ 16个月。即刻修复后,4例患者自诉影响发音,3例患者自诉咬颊(唇),8例患者自诉咀嚼功能不佳。结论    上颌无牙颌种植短牙弓即刻负重修复是针对上颌后牙区骨量不足需同期行上颌窦底提升术的一种可行的种植修复方案,在研究过渡修复期间无种植体相关并发症且修复体并发症可控,后期需行加强临时修复体强度及患者舒适度方面的研究。

关键词: 全口种植, All-on-4, 即刻修复, 短牙弓, 整体桥, 边缘骨吸收, 上颌窦底提升术, 并发症

Abstract: Objective    To analyze the clinical effect of immediate loading restoration of 6 to 9 dentures with a short dental arch in the anterior region for maxillary edentulous implant fixed restoration. Methods    Clinical and radiographic data of 10 patients,who underwent immediate loading restoration with a short dental arch for maxillary edentulous implantations in the Department of Implantology,Tianjin Stomatological Hospital,from July 2020 to December 2022,were collected for retrospective analysis. Implant placement was preoperatively designed,and a guide plate was fabricated. Four implants were implanted between the anterior walls of bilateral maxillary sinuses with immediate restoration of 6 to 9 dentures. Maxillary sinus floor elevation was performed in the distal molar region for simultaneous or delayed implant placement,and permanent restoration with a monolithic bridge was conducted after osseointegration of distal molar implants. The implant survival rate,marginal bone loss,restorative complications,and recorded patient-reported discomfort from immediate restoration to permanent restoration were analyzed. Results    A total of 40 implants were placed in the anterior region of 10 patients. The time of wearing short dental arch for temporary restorations was an average of(13.4 ± 4.5)months from immediate restoration to permanent restoration,with no implant loss and a 100% implant survival rate. The average marginal bone loss was(0.69 ± 0.51)mm,and no extensive marginal bone loss was observed. Resin restoration fracture occurred in 5 cases,with fracture time ranging from 5 to 16 months after immediate restoration. After immediate restoration,4 patients reported speech impairment,3 complained of cheek/lip biting,and 8 expressed dissatisfaction with masticatory function. Conclusion    Immediate loading restoration with a short dental arch for maxillary edentulous implantation is a feasible solution for patients with insufficient bone volume in the maxillary posterior region requiring maxillary sinus floor elevation. No implant-related complications occur during the transitional restoration phase,and restorative complications are manageable. Further research is needed to strengthen the intensity of temporary restorations and improve patient comfort.

Key words: full-mouth implantation, All-on-4, immediate restoration, short dental arch, monolithic bridge, marginal bone loss, maxillary sinus floor elevation, complications