Marinis Aristotelis, Afshari Fatemeh S, Yuan Judy Chia-Chun, Lee Damian J, Syros George, Knoernschild Kent L, Campbell Stephen D, Sukotjo Cortino
1 Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Ill.
2 Division of Restorative Sciences and Prosthodontics, The Ohio State University, Columbus, Ohio.
J Oral Implantol. 2016 Feb;42(1):46-53. doi: 10.1563/aaid-joi-D-14-00089. Epub 2014 Sep 18.
The aim of the present retrospective study was to evaluate the clinical outcomes of implant-supported overdenture treatment provided by prosthodontic specialty residents. Twenty-three patients with 25 implant-supported overdentures (IODs) participated in the study. Seventy-four implants were placed by periodontic, prosthodontics, or oral and maxillofacial surgery students. All prostheses were fabricated in the advanced prosthodontics clinic at University of Illinois at Chicago. The condition of the peri-implant soft tissue, implants, and prostheses were evaluated. Complications and any maintenance were documented. Patients completed an oral health impact profile-14 and semantic differential scale questionnaires. Statistical analyses were performed using SPSS statistical software. Twenty mandibular and 5 maxillary IODs were evaluated. Ninety-seven percent of the attachments were locators (Zest Anchors) and 3% ball attachments. None of the implants had lost osseointegration, but 14 implants (19%) had developed marginal bone loss in one-third of the implant length or more. Fourteen (19%) implants had developed dehiscence, which ranged from 1 to 4 mm. A variation in the width of the keratinized tissue, gingival, plaque, and calculus index was observed. There was a statistically significant relationship between the presence of plaque and the bleeding on probing on the buccal aspect of implants (P = .012). The incidence of dehiscence was significantly higher on the midfacial when the keratinized tissue was less than 2 mm (P < .0001). The majority of the complications were prosthetic in nature, such as broken denture teeth (74%) and worn or loose matrices (35%). Debris was observed in 19% of the locator abutments, and 36% of the overdentures were not stable in application of anterior force. Patients were compliant with oral hygiene protocols and their chewing ability was high (mean = 8.0). The overall experience was pleasant (mean = 7.5); the treatment provided good esthetics (mean = 8.3) and great satisfaction (mean = 8.5). From an educational and clinical perspective, IOD therapy has been documented to be a predictable and successful treatment option. Patients should be informed of the required maintenance and the possible complications related to IOD therapy.
本回顾性研究的目的是评估口腔修复专科住院医师提供的种植体支持覆盖义齿治疗的临床效果。23例患者的25副种植体支持覆盖义齿（IOD）参与了本研究。74颗种植体由牙周科、口腔修复科或口腔颌面外科的学生植入。所有修复体均在伊利诺伊大学芝加哥分校的高级口腔修复诊所制作。对种植体周围软组织、种植体和修复体的状况进行评估。记录并发症及任何维护情况。患者完成了口腔健康影响程度量表-14和语义差异量表问卷。使用SPSS统计软件进行统计分析。评估了20副下颌IOD和5副上颌IOD。97%的附着体为定位器（Zest锚固器），3%为球附着体。所有种植体均未丧失骨结合，但14颗种植体（19%）在种植体长三分之一或更长的长度出现了边缘骨吸收。14颗（19%）种植体出现了1至4毫米的裂开。观察到角化组织宽度、牙龈、菌斑和牙石指数存在差异。种植体颊侧菌斑的存在与探诊出血之间存在统计学上的显著关系（P = 0.012）。当角化组织小于2毫米时，面部中部裂开的发生率显著更高（P < 0.0001）。大多数并发症本质上是修复性的，如义齿牙折断（74%）和基托磨损或松动（35%）。在19%的定位器基牙上观察到碎屑，36%的覆盖义齿在前牙施加力时不稳定。患者遵守口腔卫生方案，咀嚼能力较高（平均值 = 8.0）。总体体验良好（平均值 = 7.5）；治疗提供了良好的美学效果（平均值 = 8.3）和高度满意度（平均值 = 8.5）。从教育和临床角度来看，IOD治疗已被证明是一种可预测且成功的治疗选择。应告知患者IOD治疗所需的维护以及可能出现的并发症。
