Department of Prosthodontics, College of Dentistry, New York University, New York City, , NY 11220, USA.
J Am Dent Assoc. 2012 Aug;143(8):881-9. doi: 10.14219/jada.archive.2012.0292.
In 2002 and 2009, two consensus statements-one from a symposium in Canada and one from England-were issued that recommended that the first-choice standard of care for an edentulous mandible should be the two implant-retained mandibular overdenture (IRMOD). The authors conducted a survey to determine if, in 2011, U.S. academic prosthodontic experts' opinions were aligned with those in the two consensus statements.
The authors administered a Delphi method survey to an expert panel of 16 nationally representative academic prosthodontists to determine if there is consensus on the first-choice standard of care for an edentulous mandible between the IRMOD and a conventional mandibular complete denture (CD). Consensus agreement was defined as a 70 percent agreement level among the panelists.
The panel attained consensus favoring the IRMOD for nine of the 10 parameters assessed-retention, stability, speech, masticatory efficiency, comfort while eating soft foods and hard foods, confidence in intimate situations, satisfaction and self-esteem. The exception was esthetics for which only a majority (51-69 percent) favored the IRMOD.
The panelists reached consensus that they would recommend an IRMOD instead of a CD as the first-choice standard of care for patients who are healthy or have mild systemic disease, but not for patients with severe systemic disease.
Surveyed academic prosthodontists recommend an IRMOD as the first choice standard of care when restoring an edentulous mandible of a healthy patient or a patient with mild systemic disease.
2002 年和 2009 年，加拿大和英国分别发布了两项共识声明，建议无牙下颌的首选标准治疗方法应为两个种植体支持的下颌覆盖义齿（IRMOD）。作者进行了一项调查，以确定 2011 年美国学术性修复专家的观点是否与这两项共识声明一致。
作者对 16 名具有全国代表性的学术性修复专家进行了 Delphi 方法调查，以确定在无牙下颌的首选标准治疗方法中，IRMOD 与传统下颌全口义齿（CD）之间是否存在共识。共识协议定义为专家组中 70%的人达成一致。
专家组就 10 个评估参数中的 9 个参数达成了支持 IROMD 的共识——保留、稳定性、言语、咀嚼效率、在吃软食和硬食时的舒适度、在亲密场合的信心、满意度和自尊心。唯一的例外是美观，只有多数（51-69%）人支持 IROMD。
专家组达成共识，即他们将推荐 IROMD 而不是 CD 作为健康或轻度系统性疾病患者的首选标准治疗方法，但不推荐给患有严重系统性疾病的患者。
接受调查的学术性修复专家建议在为健康患者或轻度系统性疾病患者修复无牙下颌时，将 IROMD 作为首选标准治疗方法。
