牙缺失种植修复并发症与咬合

摘要

种植体周围炎、种植牙冠修复体崩裂脱落及种植体结构破坏等是种植修复后较常见的并发症,可发生于种植单冠、联冠、种植支持式固定桥、无牙颌种植覆盖义齿及无牙颌种植固定义齿等修复类型中,且近年来呈上升趋势.种植牙修复并发症发生的原因,除与种植体及其附件的结构设计、修复材料的结构性能有关外,种植牙修复结构设计、患者的咬合功能及结构是不容忽视的重要因素.尽管牙齿具有坚硬的质地,但咀嚼应力使牙齿面及邻面等部位受到持续性磨损,牙齿近中向移位,咬合结构及功能处于持续变化的状态,此因素的影响伴随人的一生,故在实施牙种植修复时,须纳入种植手术、修复体设计及后期维护计划的各个环节.本文对种植修复后出现的并发症从咬合功能及相关结构的角度切入,从咬合因素对种植修复并发症的影响、潜在危害、处理原则及预防措施等方面进行阐述和分析.%Peri-implantitis, restoration loosening and fracture, implant structural damage are common post-restorative complications in implant rehabilitation. With an increasing incidence, they may occur in implant-supported single or splinted crowns, bridges, overdenture or fixed denture. Possible causes involve not only the design of implant components structure and characteristics of restorative materials, but also the design of restoration and the occlusal function and structure of patients. Despite the hard texture of teeth, occlusal force may cause abrasion to occlusal and proximal aspects, as well as mesial migration of tooth, leading to continuous change of occlusal structure and function through the whole life. It should be considered in implant placement surgery, design and maintenance of restorations. From considerations of occlusal function and structure, the present article reviews and elaborates the effect, potential hazard, management and prophylaxis of post-implant-restorative complications.