Karl Matthias, Winter Werner, Taylor Thomas D, Heckmann Siegfried M
Department of Prosthodontics, University of Erlangen-Nuremberg School of Dental Medicine, Erlangen, Germany.
Int J Oral Maxillofac Implants. 2004 Jan-Feb;19(1):30-7.
Fabrication and retention methods have an influence on the passivity of superstructure fit. The objective of the study was to quantify the strain development of various cemented and screw-retained fixed partial dentures (FPDs).
Forty samples of 4 different types of FPDs (10 of each type) were investigated. Each sample had 3 ITI implant abutments and 2 pontics. The 3 implants were anchored in a straight-line configuration in a measurement model simulating a real-life patient situation. Strain gauges were mounted close to the implants and on the pontics. The developing strains were recorded during cement setting and screw fixation. For statistical analysis, multivariate 2-sample tests were performed, with the level of significance set at P = .1.
All FPDs investigated revealed a considerable amount of strain, with no significant difference between cement and screw retention. Furthermore, no significant difference was found between the conventional fabrication modes for screw-retained FPDs. The lowest strains were found in prostheses that were intraorally bonded onto gold cylinders.
Because bonding of the superstructure in the oral cavity may compensate for impression and laboratory variables, restorations with the best possible passive fit can result from this retention technique. Before this technique can be recommended, the long-term stability of the adhesive layer should be investigated.
As an absolute passive fit of superstructures is not possible using conventional clinical and laboratory procedures, and as clinical fit-evaluation methods often do not detect "hidden" inaccuracies, the more sensitive strain-gauge technique should be utilized for an objective accuracy test. Reference strain values from implant-supported prostheses that have served without complications could help define a "biologically acceptable fit.
修复体的制作和固位方式会影响上部结构的贴合度。本研究的目的是量化各种粘结和螺丝固位固定局部义齿(FPD)的应变发展情况。
研究了4种不同类型的FPD的40个样本(每种类型10个)。每个样本有3个ITI种植体基台和2个桥体。3个种植体以直线排列方式固定在模拟真实患者情况的测量模型中。应变片安装在靠近种植体和桥体的位置。在粘结剂凝固和螺丝固定过程中记录产生的应变。进行多变量双样本检验以进行统计分析,显著性水平设定为P = 0.1。
所有研究的FPD都显示出相当大的应变,粘结固位和螺丝固位之间没有显著差异。此外,螺丝固位FPD的传统制作方式之间也没有发现显著差异。在口腔内粘结到金柱上的修复体中发现的应变最低。
由于上部结构在口腔内的粘结可以补偿印模和实验室变量的影响,这种固位技术可以实现尽可能最佳的被动贴合修复体。在推荐这种技术之前,应研究粘结层的长期稳定性。
由于使用传统的临床和实验室程序无法实现上部结构的绝对被动贴合,并且由于临床贴合度评估方法通常无法检测到“隐藏”的不准确之处,因此应采用更敏感的应变片技术进行客观的精度测试。来自无并发症使用的种植体支持修复体的参考应变值有助于定义“生物学上可接受的贴合度”。