- 學位論文
牙科植體受力後周圍骨高度的評估
Bone Level Evaluation After Dental Implant Loading
摘要
牙科植體已廣泛的運用在臨床工作，牙科植體在臨床使用上分成兩類埋入式(submerged) 或非埋入式(non-submerged)，主要的差別在於埋入式植體需要第二次手術將癒合基台(healing abutment)接出來，之後再行印模製做假牙，而非埋入式體可以直接印模製做假牙。 1996年Ericsson在動物實驗上利用放射線檢查與組織切片檢查，證實不管是埋入式植體或非埋入式植體，他們都有相同的軟組織貼合與適當的骨整合，2000年Buser利用動物實驗去比較在非受力的情況下埋入式與非埋入式植體邊緣骨頭的變化，得到的結果是兩者間並沒有顯著的差異。 2002年 Astrand在28個上顎前牙有牙但雙側後牙缺牙的病人口中一側置入埋入式植體另一側置入非埋入式植體，觀察植體裝上假牙時和受力一年後植體周圍骨高度，埋入式植體在假牙裝上時量測周圍骨吸收是1.9mm，受力一年後是2.1mm，非埋入式植體在假牙裝上時周圍骨吸收是1.5mm，受力一年後是1.6mm，結果顯示兩者間沒有統計上顯著性差異，但是非埋入式植體周圍骨吸收比埋入式植體較少。 本次研究埋入式植體與非埋入式植體在口腔內承受咬合力後12周、24周，對於這兩種形式的植體周圍骨吸收的變化，利用牙科數位根尖片去比較受力前和受力後植體近心與遠心周圍骨高度的吸收量，結果顯示非埋入式植體贋復前平均周圍骨高度吸收0.10mm+0.23mm，贋復後24周平均周圍骨高度吸收0.16mm+0.25mm，埋入式植體贋復前平均周圍骨高度吸收0.29mm+0.40mm，贋復後24周平均周圍骨高度吸收0.40mm+0.46mm，非埋入式植體周圍骨吸收量比埋入式植體少且有統計上顯著性差異。
並列摘要
Today, dental implants are broadly used clinically. The two types of dental implant procedures are submerged and non-submerged implants. The fundamental difference between these two procedures is that submerged implants consist of two-stage procedures involving the removal of healing abutment, followed by mold impression to produce restoration. While non-submerged implants allow direct mold impression to produce restoration. In 1996, by using radiographic examination and soft tissue biopsy on animal study, Dr. Ericsson had proved that both submerged and non-submerged implant have the same soft tissue adaptation and adequate osseointegration. In 2000, under non-loading situation on animal study, Dr. Buser had concluded that no significant difference in the marginal bone resorption either for submerged or non-submerded implant. In 2002, Astrand et al. included twenty-eight patients with a residual anterior dentition in the maxilla. The Branemark implants were used on one side and the IT1 implants on the other side of the residual dentition according to a randomization procedure. The observation period for all patients was 1 year after loading. Radiographic examination of the bone level was performed at the time of delivery of the bridge and after 1 year. The mean marginal bone resorption at delivery of the bridge was 1.9 mm for the Branemark implants and 1.5 mm for the IT1 implants. After 1 year loading, the mean marginal bone resorption was 2.1 mm for the Branemark implants and 1.6 mm for the IT1 implants. The difference between results with the two implants was not statistically significant. Although the result with two implants was not statistically significant difference, but non-submerged implants had less marginal bone resorption than submerged implants. This study adopted a retrospective medical record review design to compare the post-loading 12wks、24wks bone resorption alteration of these two types of implants. Digital periapical radiography was used to examine the differences between pre-loading and post-loading bone resorption in the bone surrounding of the implant. The result showed that non-submerged implant had less marginal bone resorption than submerged implant and had statistically significant difference.
參考文獻
延伸閱讀
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