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种植体支持并通过Dolder杆固位的无牙下颌覆盖义齿:一项5年前瞻性研究。

Overdentures in the edentulous mandible supported by implants and retained by a Dolder bar: a 5-year prospective study.

作者信息

Heschl Alexander, Payer Michael, Clar Volker, Stopper Marlene, Wegscheider Walther, Lorenzoni Martin

机构信息

Department of Prosthodontics, School of Dentistry, Medical University Graz, Graz, Austria.

出版信息

Clin Implant Dent Relat Res. 2013 Aug;15(4):589-99. doi: 10.1111/j.1708-8208.2011.00380.x. Epub 2011 Aug 11.

Abstract

PURPOSE

This prospective study was performed to evaluate the outcomes of XiVE® S plus implants (Dentsply Friadent, Mannheim, Germany) following conventional restoration with bar structures and overdentures in the edentulous mandible.

MATERIALS AND METHODS

A total of 39 patients were treated with four interforaminal implants (n = 156) splinted by a Dolder bar. Overdentures were attached to the bars after 3 months of healing. As primary outcome measures, clinical and radiological parameters were evaluated at the time of implant placement (baseline) and once a year (1, 2, 3, 4, 5 years) after functional loading. Secondary outcome measures included (i) primary stability and surgical complications, as well as (ii) Periotest® (Medizintechnik Gulden, Modautal, Germany) values, implant survival, and prosthetic complications at baseline and follow-up.

RESULTS

A total of 156 implants were placed. The vast majority (n = 149) were tightened to >30 Ncm, while torques in the range of 20-30 Ncm were obtained in the remaining cases (n = 7). Mean crestal bone levels around the implants were 0.41 mm at baseline and 1.04/1.20/1.34/1.45/1.44 mm after 1/2/3/4/5 years respectively. The mean values of the plaque, calculus, bleeding, and mucosal indices remained low throughout this period. The reported follow-up periods involved one implant loss after 3 months (survival rate: 99.4%) and one implant failure after 4 years (success rate: 98.4%). Prosthetic complications included factures of bars (n = 3) and denture teeth (n = 7). Prosthetic survival was 100%.

CONCLUSIONS

Dolder bars to restore oral implants in the edentulous mandible appear to offer a high rate of implant survival, good stability of the peri-implant tissue, and a low rate of prosthetic complications.

摘要

目的

本前瞻性研究旨在评估XiVE® S plus种植体(德国曼海姆登士柏菲兰德公司)在下颌无牙颌采用杆结构和覆盖义齿进行常规修复后的效果。

材料与方法

共39例患者接受了4枚孔间种植体(n = 156)治疗,种植体用杜德尔杆连接固定。愈合3个月后在杆上安装覆盖义齿。作为主要观察指标,在种植体植入时(基线)以及功能负载后每年(1、2、3、4、5年)评估临床和放射学参数。次要观察指标包括:(i)初期稳定性和手术并发症,以及(ii)基线和随访时的Periotest®(德国莫陶尔古尔登医疗技术公司)值、种植体存留率和修复并发症。

结果

共植入156枚种植体。绝大多数(n = 149)种植体拧紧至>30 Ncm,其余病例(n = 7)的扭矩在20 - 30 Ncm范围内。种植体周围的平均嵴顶骨水平在基线时为0.41 mm,1/2/3/4/5年后分别为1.04/1.20/1.34/1.45/1.44 mm。在此期间,菌斑、牙石、出血和黏膜指数的平均值一直较低。报告的随访期内,3个月后有1枚种植体脱落(存留率:99.4%),4年后有1枚种植体失败(成功率:98.4%)。修复并发症包括杆断裂(n = 3)和义齿牙折断(n = 7)。修复体存留率为100%。

结论

在下颌无牙颌中使用杜德尔杆修复口腔种植体似乎能提供较高的种植体存留率、良好的种植体周围组织稳定性以及较低的修复并发症发生率。

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