Mansoura University, Eldakahlia, Egypt.
Int J Prosthodont. 2012 Mar-Apr;25(2):148-56.
This report aimed to compare prosthetic aspects and patient satisfaction during a 3-year randomized clinical trial of bar- and implant-retained mandibular overdentures attached with either resilient liners or clips.
Thirty edentulous male patients (mean age: 62.5 years) received two implants in the anterior mandible after being allocated into two equal groups (according to attachment type received) using balanced randomization. After 3 months, implants were connected with resilient bars. New maxillary complete dentures were then constructed, and mandibular overdentures were retained to the bars with either clips (group I) or silicone resilient liners (group II). Subjects indicated satisfaction with their prostheses using a questionnaire and visual analog scale. Patient satisfaction and prosthetic complications were recorded for both attachments at 6 months and 1 and 3 years after overdenture insertion.
Comfort and stability with the maxillary denture and ease of hygiene procedures were rated higher in group II, while ease of handling the dentures was rated higher in group I. No significant differences in other parameters of patient satisfaction between groups were noted after 3 years. The mean number of prosthetic adjustments and repairs in group I (11.9) was significantly higher (P = .00) compared to that in group II (4.8). The most common complication in group I was clip wear, while separation of the resilient liner from the denture base was the most common problem in group II. Hyperplasia under the bar and flabby ridge in the maxilla occurred significantly more often in group I compared to group II.
Resilient liner-retained mandibular overdentures had comparable patient satisfaction, less prosthetic maintenance and costs, and less soft tissue complications when compared to clip-retained ones after 3 years.
本报告旨在比较 3 年随机临床试验中使用弹性衬垫或夹固位的杆和种植体固位下颌覆盖义齿在修复体方面和患者满意度方面的差异。
30 名无牙颌男性患者（平均年龄：62.5 岁），根据附着体类型，采用平衡随机分组法将其分为两组，每组各 15 例。3 个月后，将种植体与弹性杆连接。然后重新制作上颌全口义齿，用夹固位（I 组）或硅橡胶弹性衬垫（II 组）将下颌覆盖义齿固位到杆上。患者使用问卷和视觉模拟评分表对其义齿修复体的满意度进行评价。在义齿戴入后 6 个月、1 年和 3 年，记录两种附着体的患者满意度和修复体并发症。
在 II 组中，上颌义齿的舒适度和稳定性以及清洁程序的便利性评价较高，而在 I 组中，义齿的易操作性评价较高。3 年后，两组患者满意度的其他参数无显著差异。I 组（11.9）的义齿修复体调整和修复次数明显高于 II 组（4.8）（P=0.00）。I 组最常见的并发症是夹固位体的磨损，而 II 组最常见的问题是弹性衬垫与义齿基托分离。与 II 组相比，I 组的杆下组织增生和上颌松软牙槽嵴更为常见。
与夹固位相比，3 年后弹性衬垫固位的下颌覆盖义齿在患者满意度、修复体维护和成本以及软组织并发症方面具有相似的效果。
