目的：评价碳纤维增强“All-on-4”即刻修复体的临床效果。方法：根据纳入标准及排除标准，收集2008年4月至2014年3月在北京大学口腔医学院种植中心应用“All-on-4”技术完成的上颌或下颌无牙颌种植即刻修复体，根据有无碳纤维增强分为对照组和增强组。2008年4月至2012年12月共纳入对照组60例患者（男32例，女28例），完成即刻修复体71例（上颌28例，下颌43例）；2013年1月至2014年3月共纳入增强组23例患者（男13例，女10例），完成即刻修复体28例（上颌9例，下颌19例）。记录修复体相应患者的详细病例资料，以永久修复日期为截点，观察即刻修复体在使用期间内有无折裂，增强组即刻修复体组织表面有无纤维暴露及口内黏膜情况，扫描电镜观察碳纤维与树脂交界面的结合情况。结果：对照组和增强组即刻修复体在患者年龄［（57.3±10.1）岁 vs. （55.1±11.4）岁］、性别（男32例和女28例 vs. 男13例和女10例）、上/下颌位（上颌28例和下颌43例 vs.上颌9例和下颌19例）、术前即刻拔牙病例数（46例 vs.23例）、修复体平均使用时间［（7.8±1.3）个月 vs. （7.5±1.1）个月］及即刻修复体对颌牙列状态分布方面差异无统计学意义（P<0.05）。对照组71例即刻修复体共发生21例（29.6%）基托折裂，碳纤维增强组28例即刻修复体，在行使功能期间未发现有修复体折裂，增强组即刻修复体折裂率显著性低于对照组（P=0.001）， 且修复体组织表面均未见碳纤维暴露，口内黏膜正常无刺激。扫描电镜可见碳纤维与树脂之间结合相对紧密，纤维表面可见黏附的树脂颗粒。结论：对“Allon4”即刻修复体基托树脂进行碳纤维增强，能减少修复体折裂的发生，效果可靠。

Objective： To assess the clinical effects of carbon fiber reinforcement on the “All-on-Four” provisional prostheses. Methods:Provisional prostheses were divided into control group and carbon fiber reinforcing group according to whether carbon fiber reinforcement was used in the provisional prostheses base resin. In our study, a total of 60 patients (32 males and 28 females) with 71 provisional prostheses（28 maxilla and 43 mandible）were enrolled between April 2008 and December 2012 for control group; a total of 23 patients (13 males and 10 females) with 28 provisional prostheses (9 maxillas and 19 mandibles) were enrolled between January 2013 and March 2014 for carbon fiber reinforcing group. The information of provisional prostheses in the patients was recorded according to preoperative examination. We used the date of definitive prosthesis restoration as the cut-off point, observing whether fracture occurred on the provisional prostheses in the two groups. Additionally we observed whether fiber exposure occurred on the tissue surface of the provisional prostheses and caused mucosal irritation. The interface between the denture base resin and the fibers was examined using scanning electron microscopy (SEM). Results:The age ［(57.3±10.1) years vs.(55.1±11.4) years］, gender (32 males and 28 females vs. 13 males and 10 females), maxilla and mandible distributions (28 maxillas and 43 mandibles vs. 9 maxillas and 19 mandibles), the number of extraction jaws (46 vs. 23), the average using time ［(7.8±1.3) months vs. (7.5±1.1) months］, and the opposing dentition distributions of provisional prostheses of the patients showed no significant differences between the control and reinforcing groups. There were 21(29.6%) fractures that occurred on the 71 provisional prostheses in the control group; there was no fracture that occurred on the 28 provisional prosthesesin the carbon fiber reinforcing group. The fracture rate of the carbon fiber reinforcing group was significantly lower than that of the control group (P=0.001). No carbon fiber exposure and mucosal irritation were observed from clinical examination.SEM revealed relatively continuous contact between the fiber and acrylic resin, and the resin particles adhered on the surface of the carbon fibers. Conclusion: The addition of carbon fibers between abutments placed on “All-on-Four” provisional fixed denture base resin may be clinically effective in preventing “All-on-Four” denture fracture and can provide several advantages for clinical use.