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即刻负重种植体支持下颌覆盖义齿中种植体不同位置的影响

The effect of varying implant position in immediately loaded implant-supported mandibular overdentures.

作者信息

Shaarawy Mohammed A, Aboelross Ehab M

机构信息

Faculty of Oral & Dental Medicine, Cairo University, Cairo, Egypt.

出版信息

J Oral Implantol. 2013 Jun;39(3):345-54. doi: 10.1563/AAID-JOI-D-12-00098. Epub 2013 Jan 22.

Abstract

This study was carried out to evaluate the effect of varying implant position in immediately loaded implant-supported mandibular overdentures on peri-implant bone density, muscle activity, and patient satisfaction. Fourteen completely edentulous patients were selected for the study. After complete denture construction, patients were divided into 2 equal groups. Four dental implants were installed bilaterally in the interforaminal region in the first group, while in the second group, 4 dental implants were inserted bilaterally: 2 in the interforaminal region and 2 in the first molar area. Immediately after suturing, telescopic abutments were screwed to the implants, and the retaining caps were picked up into the fitting surface of the lower denture, which was delivered to the patient. Patients were recalled for radiographic bone density evaluation just after denture delivery and then at 3, 6, and 12 months thereafter. Muscle activities of masseter and temporalis muscles as well as patient satisfaction were also evaluated. The results of the study showed a high success rate approximating 98.2% of the immediately loaded implants. The electromyographic (EMG) records of both muscles in group 1 were significantly higher during chewing hard food after 3 months compared with group 2 (P < .05). Bone density changes were comparable in the 2 groups except at the end of the follow-up period, when group 2 showed a significant increase in peri-implant bone density values of the posteriorly placed implants compared with group 1 (P < .05). From the results of this study, it may be concluded that wide distribution of immediately loaded implants used for supporting mandibular overdentures through posterior placement beyond the interforaminal area results in a favorable response in terms of increased peri-implant bone density as well as decreased EMG activity of masseter and temporalis muscles.

摘要

本研究旨在评估即刻负重种植体支持的下颌覆盖义齿中种植体不同位置对种植体周围骨密度、肌肉活动及患者满意度的影响。选择14例全口无牙患者进行研究。完成全口义齿修复后,将患者分为两组,每组人数相等。第一组在双侧孔间区域植入4枚牙种植体,而第二组在双侧植入4枚牙种植体:2枚在孔间区域,2枚在第一磨牙区。缝合后立即将套筒冠基台拧到种植体上,并将固位帽安装到下义齿的贴合面,然后将义齿交付给患者。在义齿交付后即刻以及此后的3个月、6个月和12个月召回患者进行种植体周围骨密度的影像学评估。同时还评估了咬肌和颞肌的肌肉活动以及患者满意度。研究结果显示即刻负重种植体的成功率很高,约为98.2%。与第二组相比,3个月后第一组在咀嚼硬食物时两组肌肉的肌电图(EMG)记录均显著更高(P < 0.05)。两组的骨密度变化相当,除非在随访期结束时,此时第二组与第一组相比,后方种植体的种植体周围骨密度值显著增加(P < 0.05)。从本研究结果可以得出结论,通过在孔间区域后方进行后牙种植,广泛分布即刻负重种植体以支持下颌覆盖义齿,在增加种植体周围骨密度以及降低咬肌和颞肌的EMG活动方面会产生良好的反应。

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