毕业论文--“ALL-on-4”即刻种植修复无牙颌的临床修复护理配合.doc

“ALL-on-4”即刻种植修复无牙颌的临床修复护理配合 作者：冯琳琳　于艳红　胡秀莲　林野 【摘要】目的　“All-on-4”技术是目前国际上用来重建无牙颌患者口颌功能的新技术，国内临床应用刚刚起步，本研究主要目的旨在探讨“All-on-4”即刻种植修复技术的临床修复护理配合规范化流程、护理要点及效果，以促进该项新技术的临床推广应用，提高其治疗成功率。方法 2008年4月至2009年10月共29例无牙颌患者行All-on-4即刻修复,种植体植入当天行即刻固定义齿修复。针对国人张口度相对较小及该技术特殊要求，对所有患者进行个性化口腔种植修复专业护理，规范护理流程与技术，评价护理效果。结果 29例患者（其中上颌为8例，下颌为15例，全口无牙为6例），共植入140枚种植体，即刻修复后追踪平均10个月（6-24个月），至最后一次复查共8枚种植体脱落，其余种植体行使功能良好，种植体存留率为94.3%。患者对修复过程中护理效果的满意度调查结果显示27例患者均对即刻修复效果满意，对治疗过程护理技术非常满意27例，满意2例。结论 规范的口腔种植专业护理配合保证了无牙颌All-on-4即刻修复顺利进行，使整个修复治疗过程的程序化，简单化，起到关键性作用。 【关键词】即刻修复　ALL-on-4　护理　种植 【Abstract】 Objective To evaluate the key points of nursing management and technique during “All-on-4”implant operation and its clinical results. Methods 29 full edentulous patients underwent “All-on-4”implant insertion surgery from April 2008 to October 2009, and the complete-arch all- acrylic prostheses were delivered on the operation day. Surgical care management according to the specificity of implantology was used peri-operatively. Sterility test was applied regularly. Evaluation of the patient satisfaction to the perioperative care was undergone in the study. Results 29 patients were included in the study and among them 8 were edentulous maxilla, 15 were edentulous mandible and 6 were full jaw edentulous arches.140 implants were placed and restored immediately on the operation day. 8 implants were lost after functioning 1-2 months. All the patients were satisfied with the final results and nursing management during treatment. Conclusions Professional nursing management and prosthetic care techniques can predictably provide security during immediate function of the fixed provisional denture for the edentulous arches with high patient satisfactions. 【Key words】immediate prostheses All-on-four nursing dental implant 无牙颌修复一直是国际上公认的修复难题，与传统全口义齿相比，种植修复能最大限度重建无牙颌患者的口颌功能，明显改善患者的生存质量，临床效果满意且长期成功率高，而经典的无牙颌种植修复方法存在治疗周期长，医疗费用高，使其推广应用受限。[1-4]All-on-4即刻种植固定修复无牙颌是近年来国际上出现的新技术，目前国际上仅有少数病例报告，国内仅有一篇临床研究报道；该技术特点是通过植入四颗种植体，其中远中种植