倾斜种植体修复骨量不足上颌后牙区牙列缺损的研究进展

doi:10.13591/j.cnki.kqyx.2025.02.011

摘要/Abstract

摘要：

上后牙区的牙列缺损十分常见,由于缺牙后牙槽骨的吸收以及上颌窦的存在,上后牙区牙列缺损的种植修复往往面临着可用骨高度不足的问题。目前临床上解决上颌后牙区骨量不足的方法包括上颌窦底提升术、短种植体、减数修复、悬臂梁和倾斜种植体等。倾斜植入种植体,充分利用上颌后牙区可用骨量完成修复,具备操作简便、创伤小等优点。本综述旨在回顾讨论倾斜种植技术用于修复上颌后牙区牙列缺损的研究现状,为该技术的临床应用提供一定参考。

关键词: 倾斜种植体, 种植修复, 骨量不足, 牙列缺损

Abstract:

Dentition defects in upper and posterior teeth are very common. Due to the absorption of alveolar bone and the existence of maxillary sinus, implant repair of dentition defects in upper and posterior teeth is often faced with the problem of insufficient bone height. At present, the clinical methods to solve the bone deficiency of maxillary posterior teeth include maxillary sinus floor lifting, short implant, reduced restoration, cantilever beam and inclined implant and so on. The inclined implant can make full use of the bone mass in the maxillary posterior tooth area to complete the restoration, which has the advantages of simple operation and less trauma. The objective of this review is to review and discuss the research status of oblique implant technique in the repair of maxillary posterior dentition defects, and to provide some reference for the clinical application of this technique.

Key words: inclined implant, implant restoration, alveolar bone insufficiency, dentition defect

中图分类号:

R782.13

段文君, 王柏翔. 倾斜种植体修复骨量不足上颌后牙区牙列缺损的研究进展[J]. 口腔医学, 2025, 45(2): 139-145.

DUAN Wenjun, WANG Baixiang. Research progress of inclined implant in repairing dentition defect in maxillary posterior region with insufficient bone mass[J]. Stomatology, 2025, 45(2): 139-145.

图/表 1

表1

倾斜种植的临床效果评价"

发表时间作者研究类型随访时间样本量主要研究指标结论牙位修复类型
2010年 5月Del Fabbro 等^[37]综述1年10项研究,462名受试者和1 992个种植体(倾斜种植体966例、轴向种植体1 026例)失败率、边缘骨吸收无统计学差异全牙弓未限制
2012年 7月Menini等^[41]综述1年11项研究,324名受试者和1 623个种植体(倾斜种植体778例、轴向种植体845例)失败率、边缘骨吸收无统计学差异上颌全牙弓种植支持固定局部义齿
2012年 7月Ata-Ali等^[36]Meta分析>1年13项研究,1 211个种植体(倾斜种植体545例、轴向种植体666例)成功率、边缘骨吸收无统计学差异未注明未限制
2012年 9月Monje等^[44]Meta分析3~5年8项研究,1 317个种植体(倾斜种植体615例、轴向种植体702 例)边缘骨吸收倾斜植入边缘骨吸收量更大未注明未限制
2014年 9月Chrcanovic等^[34]Meta分析4个月~ 10年44项研究,10 761个种植体(倾斜种植体5 029例、轴向种植体5 732例)失败率、边缘骨吸收、术后感染率上颌倾斜植入失败率高,边缘骨吸收量差异无统计学意义全牙弓未限制
2018年 10月Lin等^[43]综述1~7年42项研究边缘骨吸收、植入物存留率、患者报告的结果无统计学差异未注明未限制
2018年 10月Apaza Alccay- huaman等^[39]Meta分析3~10年13项研究,1 849名受试者和7 568个种植体失败率、边缘骨吸收、植入物存留率无统计学差异全牙弓未限制
2021年 6月Cortés-Bretón Brinkmann等^[40]Meta分析5~17年8项研究,1 113名受试者和3 987个种植体(倾斜种植体1 951例、轴向种植体2 036例)成功率、边缘骨吸收、植入物存留率、并发症、>5 年后功能倾斜植入并发症发病率更高,余对比项无统计学差异全牙弓未限制
2021年 8月Mehta等^[38]Meta分析3年11项研究,351名受试者和1 148个种植体(倾斜种植体510例、轴向种植体638例)边缘骨吸收、植入物存留率无统计学差异上颌全牙弓all-on-4修复
2022年 11月Batista等^[42]Meta分析1~5年9项研究,258名受试者和604个种植体(倾斜种植体269例、轴向种植体335例)边缘骨吸收、植入物存留率无统计学差异未注明种植支持固定局部义齿

表1

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