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北京大学学报（医学版） ›› 2019, Vol. 51 ›› Issue (1): 136-144. doi: 10.19723/j.issn.1671-167X.2019.01.024

• 论著 • 上一篇    下一篇

无牙颌患者locator附着体种植覆盖义齿修复后口腔卫生维护的纵向研究

刘潇倩1,陈秋雯1,冯海兰1,王兵2,屈健2,孙振2,衡墨迪2,潘韶霞1,△()   

  1. 1. 北京大学口腔医学院·口腔医院, 修复科, 北京　100081
    2. 义齿加工中心,　国家口腔疾病临床医学研究中心　口腔数字化医疗技术和材料国家工程实验室　口腔数字医学北京市重点实验室, 北京　100081
  • 收稿日期:2018-10-08 出版日期:2019-02-18 发布日期:2019-02-26
  • 通讯作者: 潘韶霞 E-mail:panshaoxia@vip.163.com
  • 基金资助:
    北京大学口腔医学院临床新技术新疗法项目基金(PKUSSNCT-09B20);教育部留学回国人员科研启动基金(2012-940)

Oral hygiene maintenance of locator attachments implant overdentures in edentulous population: A longitudinal study

Xiao-qian LIU1,Qiu-wen CHEN1,Hai-lan FENG1,Bing WANG2,Jian QU2,Zhen SUN2,Mo-di HENG2,Shao-xia PAN1,△()   

  1. 1. Department of Prosthodontics, Beijing 100081, China
    2. Department Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2018-10-08 Online:2019-02-18 Published:2019-02-26
  • Contact: Shao-xia PAN E-mail:panshaoxia@vip.163.com
  • Supported by:
    Supported by the Program for New Clinical Techniques Therapies of Peking University and School and Hospital of Stomatology(PKUSSNCT-09B20);and the Scientific Research Foundation for Returned Overseas Chie Scholars, States Education Ministry(2012-940)

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摘要：

目的:调查无牙颌患者locator附着体种植覆盖义齿修复后口腔卫生维护状况,分析其口腔卫生维护行为、卫生状况与种植体周围软硬组织健康的相关性。方法:纳入2012年1月至2016年5月于北京大学口腔医院修复科接受locator附着体种植覆盖义齿修复的无牙颌患者,复查时记录种植体周围病的发生情况、改良菌斑指数(modified plaque index, mPLI)、探诊出血指数(sulcus bleeding index, SBI)、牙龈指数(gingival index, GI)、探诊深度(probing depth, PD)等,并利用X线平行投照法观察边缘骨吸收,同时调查患者对附着体的日常清洁行为。分析患者的口腔卫生维护行为、卫生状况与种植体周围病发生率的关系。结果:共纳入50名患者(125枚种植体),平均随访了22个月(6~54个月),平均mPLI、SBI、GI分别为1.4±1.2、0.8±0.7、0.7±0.6,PD为(2.2±0.7) mm,近远中边缘骨吸收分别为(1.1±1.1) mm、(0.9±0.9) mm。种植体周围黏膜炎的发生率为49.6%,种植体周围炎的发生率为0。口腔卫生差(mPLI≥2)的患者种植体周围黏膜炎的发生率是口腔卫生良好者(mPLI<1)的11.9倍,每日清洁附着体两次及以上的患者mPLI得分显著低于清洁次数不足两次的患者(P<0.05)。结论:无牙颌患者种植locator附着体种植覆盖义齿修复后的口腔卫生维护不足,口腔卫生维护不良与无牙颌患者种植体周围黏膜炎的发生相关,口腔卫生差的患者种植体发生黏膜炎的风险是口腔卫生良好者的11.9倍,附着体的清洁是患者应关注的重点内容。

关键词: 无牙颌, 牙种植体, locator附着体, 口腔卫生

Abstract:

Objective: To investigate the oral hygiene status of edentulous patients with locator attachments implant overdentures (IOD) and to analyze the relationship among daily hygiene behavior, oral hygiene status and peri-implant diseases. Methods: Edentulous patients who received IOD treatment with locator attachments from January 2012 to May 2016 were recruited. Clinical and radiographic examinations were conducted to assess the peri-implant tissue status. Modified plaque index (mPLI), sulcus bleeding index (SBI), gingival index (GI), and probing depth (PD) were recorded and peri-implant marginal bone loss (MBL) was measured using paralleling projection technique. Patients’ peri-implant oral hygiene maintainence habits were investigated. The correlation between peri-implant diseases and oral hygiene status and behaviors was analyzed. Results: Fifty patients (125 implants) with an average follow-up time of 22 months (6-54 months) were enrolled. The mean values of mPLI, SBI, and GI were 1.4±1.2, 0.8±0.7, and 0.7±0.6, respectively. Average PD was (2.2±0.7) mm. Mesial and distal maginal bone resorptions were (1.1±1.1) mm and (0.9±0.9) mm, respectively. The prevalance of mucositis and peri-implantitis of the implants were 49.6% and 0. The prevelance of mucositis in the patients with poor oral hygiene (mPLI≥2) was 11.9 times as much as that of those with adequate oral hygiene (mPLI<1). The patients who performed oral hygiene procedure on attachments at least twice a day achieved much lower mPLI scores than those who cleaned less than twice a day. Conclusion: Oral hygiene condition in the group of patients with implant overdentures was poor, and it contributed to increased risk of peri-implant mucositis. The prevelance of musositis of the paitients with poor oral hygiene was 11.9 times as much as that of those with proper oral hygiene. Patients wearing IOD should pay more attention to the hygiene of the attachments.

Key words: Edentulous jaw, Dental implants, Locator attachments, Oral hygiene

中图分类号: 

  • R783.4

表1

50名患者牙列缺失、缺损状况"

Diagnosis n (%)
Edentulous mandible and maxila 24 (48)
Partially edentulous maxilla and edentulous mandible 17 (34)
Partially edentulous maxilla and mandible 1 (2)
Complete dentition of maxilla and edentulous mandible 8 (16)
Total 50 (100)

表2

125枚种植体的各项检查指标得分"

Clinical indicators Mean±standard deviation
Modified plaque index 1.4±1.2
Sulcus bleeding index 0.8±0.7
Gingival index 0.7±0.6
Probing depth/mm 2.2±0.7
Buccal keratinized mucosa index/mm 3.2±1.4
Lingual keratinized mucosa index/mm 2.1±1.2

图1

附着体上的菌斑堆积"

表3

不同年龄分层的改良菌斑指数得分"

Age group Modified plaque index (x?±s)
<60 years old (n=11) 1.2±1.2
60-70 years old (n=22) 1.4±1.1
70-80 years old (n=13) 1.4±1.0
≥ 80 years old (n=4) 2.3±0.5

图2

种植体周围黏膜炎"

表4

各自变量因素分级及相应种植体周围炎、黏膜炎的发生情况"

Factors Number of implants Healthy mucosa Per-implant mucositis Peri-implantitis
Main cause of tooth loss
Periodontitis
Non-periodontitis
86
39
39 (45.3%)
24 (61.5%)
47 (54.7%)
15 (38.5%)
0
0
Jaw grouping
Full edentulous jaw
Non-full edentulous jaw
70
55
40 (57.1%)
23 (41.8%)
30 (42.9%)
32 (58.2%)
0
0
mPLI grouping
Bad
General
Good
37
32
56
3 (8.1%)*
8 (25.0%)
52 (92.9%)
34 (81.9%)*
24 (75.0%)
4 (7.1%)
0
0
0
Follow-up time after restoring
Above 48 months
36-48 months
24-36 months
12-24 months
6-12 months
4
4
23
55
39
0 (0)
2 (50.0%)
17 (73.9%)
19 (34.5%)#
25 (56.8%)
4 (100.0%)
2 (50.0%)
6 (26.1%)
36 (65.4%)
14 (43.2%)
0
0
0
0
0
Brand of the implant
Straumann
Bego
65
60
25 (38.5%)
38 (63.3%)
40 (61.5%)
22 (36.7%)
0
0
Implant level
Bone level
Soft tissue level
82
43
46 (56.1%)
17 (39.5%)
36 (43.9%)
26 (60.5%)
0
0
Smoking
Yes
No
12
113
1 (8.3%)△
62 (54.9%)
11 (91.7%)△
51 (45.1%)
0
0
Diabetes
Yes
No
12
113
5 (41.7%)
58 (51.3%)
7 (58.3%)
55 (48.7%)
0
0

图3

患者对附着体不同清洁行为的mPLI、SBI、GI得分对比"

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