Elsyad Moustafa Abdou, Mohamed Shahinaz Sayed, Shawky Ahmad Fathalla
Int J Prosthodont. 2017 May/June;30(3):260–265. doi: 10.11607/ijp.5114. Epub 2017 Mar 20.
This retrospective study compared posterior mandibular residual ridge resorption with two different retentive mechanisms for overdentures after 7 years.
A convenience sample of 18 edentulous men was assigned to one of two equal groups. Two implants were placed in the mandibular canine areas for each patient using the conventional two-stage surgical protocol, and the implants were splinted with a round bar 3 months later. New mandibular overdentures were then connected to the bars with clips (clip-retained overdentures, CR group) or resilient liners (resilient liner-retained overdentures, RR group). Posterior mandibular ridge resorption (PMRR) was recorded using proportional measurements and posterior area index (PAI) on panoramic radiographs taken immediately after overdenture insertion (T) and 7 years later (T). A linear regression model was used to verify the relationship between PAI and the following considerations: attachment type, age, initial mandibular ridge height, period of mandibular edentulism, number of previously worn dentures, and relining events.
After 7 years, the RR group demonstrated a significantly (P = .014) higher change in PAI (0.11 ± 0.02) than the CR group (0.06 ± 0.04). The average PMRR for each mm of posterior mandibular ridge was 0.79 mm (0.11 mm/year) in the CR group and 1.4 mm (0.2 mm/year) in the RR group. Attachment type, initial mandibular ridge height, and relining times were significantly correlated with change in the PAI (P = .004, P = .035, and P = .045, respectively).
Within the limitations of this preliminary study's design, it was observed that following a 7-year period of use, resilient liner attachments for bar/implant-retained overdentures appear to be associated with greater posterior mandibular ridge resorption when compared to clip attachments.
本回顾性研究比较了7年后采用两种不同固位机制的下颌覆盖义齿的下颌后部残余牙槽嵴吸收情况。
选取18名无牙男性组成便利样本,分为两组,每组人数相等。采用传统的两阶段手术方案,为每位患者在下颌尖牙区植入两颗种植体,3个月后用圆杆将种植体连接在一起。然后,用夹子将新的下颌覆盖义齿连接到杆上(夹子固位覆盖义齿,CR组),或用弹性衬垫连接(弹性衬垫固位覆盖义齿,RR组)。在下颌覆盖义齿插入后即刻(T)和7年后(T)拍摄全景X线片,使用比例测量法和后部面积指数(PAI)记录下颌后部牙槽嵴吸收(PMRR)情况。采用线性回归模型验证PAI与以下因素之间的关系:固位类型、年龄、初始下颌牙槽嵴高度、下颌无牙时间、既往佩戴义齿数量和重衬次数。
7年后,RR组的PAI变化(0.11±0.02)显著高于CR组(0.06±0.04)(P = 0.014)。CR组下颌后部牙槽嵴每毫米的平均PMRR为0.79 mm(0.11 mm/年),RR组为1.4 mm(0.2 mm/年)。固位类型、初始下颌牙槽嵴高度和重衬次数与PAI变化显著相关(分别为P = 0.004、P = 0.035和P = 0.045)。
在本初步研究设计的局限性内,观察到在使用7年后,与夹子固位相比,杆/种植体固位覆盖义齿的弹性衬垫固位似乎与下颌后部牙槽嵴吸收增加有关。