Private Practice, Mobile, AL, USA.
Clin Oral Implants Res. 2014 Feb;25(2):207-13. doi: 10.1111/clr.12085. Epub 2012 Dec 21.
Removable partial dentures (RPDs) represent standard treatment for partial edentulism despite major shortcomings. To alleviate these shortcomings, endosseous implants provide support and stability as well as contribute to maintenance of alveolar bone. This prospective, within subject, time series study evaluated patient-based outcomes of RPDs compared to implant-supported removable partial dentures (ISRPDs). The study hypothesis was that the ISRPD would substantially improve oral health quality of life for patients.
Seventeen patients requesting new mandibular Kennedy I or II RPDs received one 6-mm dental implant in one or both of the posterior edentulous areas. After healing, conventional RPDs were fabricated and delivered. Twelve weeks later, second-stage surgery was performed, and ball abutments with Clix attachments were inserted, thereby converting the prostheses to ISRPDs. Oral health quality of life was evaluated using the 49-item Oral Health Impact Profile (OHIP-49) questionnaire. The OHIP-49 was administered prior to treatment (baseline), at 6 and 12 weeks following RPD delivery and at 6 and 12 weeks following ISRPD conversion. Radiographic evaluation was performed at 6 and 12 weeks following ISRPD conversion. In statistical analysis, a fixed-slope random intercept variance components model took account of the multiple observations per person over time.
In 17 subjects, 29 of 30 implants survived. The failed implant was replaced without complications. Abutment complications were limited to one abutment loosening and one attachment replacement. Minor prosthodontic complications were recorded. The OHIP-49 score reduced by 11.8 points, on average, at 12 weeks following ISRPD conversion (P = 0.011).
Patients reported improved oral health following conversion to an ISRPD from RPD. The ISRPD involving short implants is one treatment option that should be considered when treatment planning Kennedy Class I and II patients.
尽管存在重大缺陷，可摘局部义齿（RPD）仍是部分缺牙的标准治疗方法。为了缓解这些缺陷，骨内种植体提供了支持和稳定性，并有助于维持牙槽骨。本前瞻性、个体内、时间序列研究评估了 RPD 与种植体支持可摘局部义齿（ISRPD）相比患者的治疗效果。研究假设是 ISRPD 将大大提高患者的口腔健康生活质量。
17 名要求制作新下颌 Kennedy I 或 II 类 RPD 的患者在后牙无牙区各植入 1 枚 6mm 牙科种植体，植入后进行愈合。愈合后制作常规 RPD，并交付使用。12 周后，进行二期手术，插入球基台和 Clix 附着体，从而将义齿转换为 ISRPD。使用 49 项口腔健康影响量表（OHIP-49）问卷评估口腔健康生活质量。在治疗前（基线）、RPD 交付后 6 周和 12 周以及 ISRPD 转换后 6 周和 12 周进行 OHIP-49 问卷调查。在 ISRPD 转换后 6 周和 12 周进行放射学评估。在统计分析中，采用固定斜率随机截距方差分量模型考虑了随时间对每个人的多次观察。
在 17 名受试者中，30 枚种植体中有 29 枚存活。失败的种植体更换后无并发症。基台并发症仅限于 1 个基台松动和 1 个附件更换。记录了轻微的修复体并发症。ISRPD 转换后 12 周，OHIP-49 评分平均降低 11.8 分（P=0.011）。
患者在转换为 ISRPD 后报告口腔健康状况得到改善。涉及短种植体的 ISRPD 是 Kennedy 类 I 和 II 患者治疗计划的一种治疗选择。
