传统牙种植体与微型牙种植体用于下颌覆盖义齿的比较临床研究：一项随机临床试验

Comparative Clinical Study of Conventional Dental Implants and Mini Dental Implants for Mandibular Overdentures: A Randomized Clinical Trial.

作者信息

Aunmeungtong Weerapan, Kumchai Thongnard, Strietzel Frank P, Reichart Peter A, Khongkhunthian Pathawee

机构信息

Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Thailand.

Associate Professor, Department of Oral Surgery, Faculty of Dentistry, Chiang Mai University, Thailand.

出版信息

Clin Implant Dent Relat Res. 2017 Apr;19(2):328-340. doi: 10.1111/cid.12461. Epub 2016 Nov 1.

DOI:10.1111/cid.12461

PMID:27804205

Abstract

BACKGROUND

Dental implant-retained overdentures have been chosen as the treatment of choice for complete mandibular removable dentures. Dental implants, such as mini dental implants, and components for retaining overdentures, are commercially available. However, comparative clinical studies comparing mini dental implants and conventional dental implants using different attachment for implant-retained overdentures have not been well documented.

PURPOSE

To compare the clinical outcomes of using two mini dental implants with Equator attachments, four mini dental implants with Equator attachments, or two conventional dental implants with ball attachments, by means of a randomized clinical trial.

MATERIALS AND METHODS

Sixty patients received implant-retained mandibular overdentures in the interforaminal region. The patients were divided into three groups. In Groups 1 and 2, two and four mini dental implants, respectively, were placed and immediately loaded by overdentures, using Equator attachments. In Group 3, conventional implants were placed. After osseointegration, the implants were loaded by overdentures, using ball attachments. The study distribution was randomized and double-blinded. Outcome measures included changes in radiological peri-implant bone level from surgery to 12 months postinsertion, prosthodontic complications and patient satisfaction.

RESULTS

The cumulative survival rate in the three clinical groups after one year was 100%. There was no significant difference (p < 0.05) in clinical results regarding the number (two or four) of mini dental implants with Equator attachments. However, there was a significant difference in marginal bone loss and patient satisfaction between those receiving mini dental implants with Equator attachments and conventional dental implants with ball attachments. The marginal bone resorption in Group 3 was significantly higher than in Groups 1 and 2 (p < 0.05); there were no significant differences between Groups 1 and 2. There was no significant difference in patient satisfaction between Groups 1 and 2 but it was significantly higher than that in Group3 (p < 0.05).

CONCLUSIONS

Two and four mini dental implants can be immediately used successfully for retaining lower complete dentures, as shown after a 1-year follow up.

摘要

背景

牙种植体支持的覆盖义齿已被选为下颌全口可摘义齿的首选治疗方法。牙种植体，如微型牙种植体，以及用于固定覆盖义齿的部件，在市场上均有销售。然而，关于使用不同附着体的微型牙种植体和传统牙种植体用于牙种植体支持覆盖义齿的比较临床研究尚未得到充分记录。

目的

通过一项随机临床试验，比较使用两个带有赤道附着体的微型牙种植体、四个带有赤道附着体的微型牙种植体或两个带有球帽附着体的传统牙种植体的临床效果。

材料与方法

60例患者在双侧下颌孔间区域接受了种植体支持的下颌覆盖义齿修复。患者被分为三组。在第1组和第2组中，分别植入两个和四个微型牙种植体，并立即用带有赤道附着体的覆盖义齿进行加载。在第3组中，植入传统种植体。骨整合完成后，用带有球帽附着体的覆盖义齿对种植体进行加载。研究分配是随机且双盲的。观察指标包括从手术到植入后12个月种植体周围骨水平的影像学变化、修复并发症和患者满意度。

结果

三个临床组一年后的累积生存率均为100%。对于带有赤道附着体的微型牙种植体数量（两个或四个），临床结果无显著差异（p < 0.05）。然而，接受带有赤道附着体的微型牙种植体的患者与接受带有球帽附着体的传统牙种植体的患者在边缘骨丢失和患者满意度方面存在显著差异。第3组的边缘骨吸收明显高于第1组和第2组（p < 0.05）；第1组和第2组之间无显著差异。第1组和第2组患者满意度无显著差异，但显著高于第3组（p < 0.05）。