Tipton Paul A
St. Ann's Dental Clinic, Manchester, United Kingdom.
J Esthet Restor Dent. 2002;14(4):208-16. doi: 10.1111/j.1708-8240.2002.tb00166.x.
Restoration of the edentulous jaw with dental implants can be achieved using either an implant-supported prosthesis, such as a fixed bridge, or an implant-retained prosthesis, such as a traditional overdenture. The implant-retained prostheses use edentulous ridges as primary stress-bearing regions, and through stress-breaking mechanisms, the implants are not loaded during function. However, the success rates of maxillary overdentures do not appear to be as good as for mandibular overdentures; this may be attributable to the adverse loading conditions, short implant length, poor quality of bone, number of implants used, flexible bar design, or poor treatment planning. Many articles have also described the numerous problems and multiple visits required in maintaining a traditional bar-retained overdenture restoration, often making it more expensive in the long term than a fixed restoration. The milled bar implant-supported prosthesis offers the benefits of both fixed and removable restorations. Its infrastructure provides the same rigidity as the fixed restoration, owing to the precise fit to the superstructure, which is removable, to promote adequate access for hygiene, yet it still provides lip support and maintains close contact with the soft tissues. These advantages enhance phonetics, esthetics, correct lip support, maintenance, and patient comfort.
使用牙种植体修复无牙颌可采用种植体支持的修复体，如固定桥，或种植体固位的修复体，如传统覆盖义齿。种植体固位的修复体将无牙嵴作为主要的应力承载区域，通过应力中断机制，种植体在功能过程中不承受负荷。然而，上颌覆盖义齿的成功率似乎不如下颌覆盖义齿；这可能归因于不利的负荷条件、种植体长度短、骨质质量差、使用的种植体数量、柔性杆设计或治疗计划不佳。许多文章还描述了维护传统杆固位覆盖义齿修复体所需的众多问题和多次就诊，从长远来看，这通常使其比固定修复体更昂贵。铣削杆种植体支持的修复体兼具固定和可摘修复体的优点。其基础结构与固定修复体具有相同的刚性，这得益于其与可摘上部结构的精确匹配，从而便于进行充分的口腔卫生清洁，同时它仍能提供唇部支撑并与软组织保持紧密接触。这些优点改善了语音、美观、唇部支撑的正确性、维护以及患者舒适度。
