Payne Alan G T, Tawse-Smith Andrew, Wismeijer Daniel, De Silva Rohana K, Ma Sunyoung
Prosthodontist, Private Practice, Whangarei, New Zealand.
Oral Implantology Research Group, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
Clin Oral Implants Res. 2017 Jan;28(1):116-125. doi: 10.1111/clr.12769. Epub 2016 Jan 22.
To determine implant survival and prosthodontic maintenance of implant-assisted mandibular removable partial dentures in a multicentre prospective study up to 10 years.
Forty-eight participants with mandibular distal extension partial dentures were selected. A control group of 12 New Zealand participants had new conventional mandibular partial dentures made. Three test groups of 36 participants in New Zealand (n = 12), the Netherlands (n = 12) and Colombia (n = 12) had bilateral distal implants placed. Surgical and prosthodontic outcomes were documented with only healing caps placed (Stage 1) and with an attachment system (Stage 2).
No implants failed after 3 years. Four late implant failures in three participants occurred in New Zealand (two unilateral implant failures after 5 and 8 years and two bilateral implant failures in the same participant after 6 and 10 years); two unilateral late implant failures occurred in the Netherlands and no late failures in Colombia. Implant survival rate was 92% by 10 years. Resonance frequency measurements were taken at surgery implant stability quotient (ISQ) 62.44 ± 7.46; range 40 - 79), baseline (ISQ 63.22 ± 6.17; range 50 - 74) and after 3 years (ISQ 66.38 ± 6.77; range 55 - 83). In New Zealand and Colombia, measured crestal bone levels were 2.03 ± 0.71 mm and 2.20 ± 0.81 mm, respectively, at baseline and 3 years. For Stage I, principal prosthodontic maintenance issues were loose healing caps among 10 New Zealand participants, four Colombian participants and one Netherlands participant. For Stage 2, matrix activation and overdenture puncture fractures resulted in 41 events (25 participants) in New Zealand over 10 years, whilst over 3 years, there were 14 events in nine Colombian participants and six events in five Netherlands participants.
This clinical multicentre research complements previous case reports, case series, retrospective and prospective studies on the notion of implant-assisted removable partial dentures for partially edentulous patients. Late implant failures and increased prosthodontic maintenance when an attachment system is used identify the need for further research, including more robust statistical analyses.
在一项长达10年的多中心前瞻性研究中，确定种植体支持的下颌可摘局部义齿的种植体存留率和修复体维护情况。
选取48例下颌远中游离端局部义齿患者。12名新西兰参与者组成对照组，制作新的传统下颌局部义齿。36名参与者分为3个试验组，新西兰（n = 12）、荷兰（n = 12）和哥伦比亚（n = 12）各12名，双侧植入远中种植体。记录手术和修复结果，仅放置愈合帽（第1阶段）和使用附着系统（第2阶段）。
3年后无种植体失败。新西兰有3名参与者出现4例种植体晚期失败（2例分别在5年和8年后出现单侧种植体失败，1例在6年和10年后出现双侧种植体失败）；荷兰出现2例单侧种植体晚期失败，哥伦比亚无晚期失败病例。10年后种植体存留率为92%。在手术时（种植体稳定性商数[ISQ] 62.44 ± 7.46；范围40 - 79）、基线时（ISQ 63.22 ± 6.17；范围50 - 74）和3年后（ISQ 66.38 ± 6.77；范围55 - 83）进行共振频率测量。在新西兰和哥伦比亚，基线时和3年后测量的牙槽嵴骨水平分别为2.03 ± 0.71 mm和2.20 ± 0.81 mm。对于第1阶段，主要的修复体维护问题是10名新西兰参与者、4名哥伦比亚参与者和1名荷兰参与者的愈合帽松动。对于第2阶段，在10年期间，新西兰有41起事件（25名参与者）是由基质激活和覆盖义齿穿刺骨折导致的，而在3年期间，9名哥伦比亚参与者有14起事件，5名荷兰参与者有6起事件。
这项临床多中心研究补充了之前关于部分牙列缺损患者种植体支持的可摘局部义齿概念的病例报告、病例系列、回顾性和前瞻性研究。使用附着系统时种植体晚期失败和修复体维护增加表明需要进一步研究，包括更有力的统计分析。
