Gibreel Mona, Fouad Mohammed, El-Waseef Fatma, El-Amier Nesma, Marzook Hamdy
1 Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
2 Department of Oral Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
J Oral Implantol. 2017 Aug;43(4):273-281. doi: 10.1563/aaid-joi-D-16-00148. Epub 2017 Jun 19.
The objective of this research was to clinically compare peri-implant tissue health of bar-clips vs silicone-resilient liners used with bilateral posterior bars for retaining 4 implant-supported mandibular overdentures. Thirty completely edentulous male patients (mean age, 65 years) were randomly assigned into 2 equal groups. Each patient received 4 implants in the canine and first molar regions of the mandible using a flapless surgical technique. Mandibular overdentures were immediately connected to the implants with bilateral prefabricated instant adjusting bars. According to the method of retention to the bar, 1 group was retained with clips (GI), whereas the other group was retained with a silicone-resilient soft liner (GII). Peri-implant tissue health was evaluated clinically in terms of plaque scores (MPI), bleeding scores (MBI), probing depth (PD), and implant stability (IS). MPI, MBI, and PD were measured at mesial, distal, buccal, and lingual surfaces of each implant. Evaluations were performed 2 weeks (T0), 6 months (T6), and 12 months (T12) after overdenture insertion. Implants of GI with clips demonstrated significant increase in plaque, bleeding, and PD scores compared with those of GII with silicone-resilient liner at all observation times. Implants in GI demonstrated a significant decrease in implant stability compared with those of GII at T6 and T12 anteriorly and at T12 posteriorly. Resilient liners are considered better than bar-clips when used with bilateral posterior bars for retaining implant-supported mandibular overdentures in terms of peri-implant soft tissue health. Bilateral posterior ready-made bars cannot be proposed as a promising design for supporting implant-assisted mandibular overdentures.
本研究的目的是临床比较用于双侧后杆以固定4颗种植体支持的下颌覆盖义齿的杆夹与硅橡胶弹性衬垫的种植体周围组织健康状况。30名完全无牙的男性患者（平均年龄65岁）被随机分为两组。每位患者使用无瓣手术技术在下颌犬牙和第一磨牙区域植入4颗种植体。下颌覆盖义齿立即通过双侧预制的即时调整杆与种植体相连。根据与杆的固定方法，一组用夹子固定（GI组），而另一组用硅橡胶弹性软衬垫固定（GII组）。从菌斑评分（MPI）、出血评分（MBI）、探诊深度（PD）和种植体稳定性（IS）方面对种植体周围组织健康状况进行临床评估。在每个种植体的近中、远中、颊侧和舌侧表面测量MPI、MBI和PD。在覆盖义齿植入后2周（T0）、6个月（T6）和12个月（T12）进行评估。在所有观察时间，与使用硅橡胶弹性衬垫的GII组相比，使用夹子的GI组种植体的菌斑、出血和PD评分显著增加。在T6和T12时，GI组种植体在前部以及T12时在后部的种植体稳定性与GII组相比显著降低。就种植体周围软组织健康而言，当与双侧后杆一起用于固定种植体支持的下颌覆盖义齿时，弹性衬垫被认为比杆夹更好。双侧后预制杆不能被认为是支持种植体辅助下颌覆盖义齿的有前景的设计。
