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无牙颌印模技术:准确性的体内比较。

Edentulous jaw impression techniques: An in vivo comparison of trueness.

机构信息

Research and Teaching fellow, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.

Research and Teaching Assistant, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.

出版信息

J Prosthet Dent. 2019 Apr;121(4):623-630. doi: 10.1016/j.prosdent.2018.08.016. Epub 2018 Dec 21.

Abstract

STATEMENT OF PROBLEM

Simplified edentulous jaw impression techniques have gained popularity, while their validity has not yet been evaluated.

PURPOSE

The purpose of this clinical study was to compare the trueness of maxillary edentulous jaw impressions made with irreversible hydrocolloid (ALG), polyvinyl siloxane (PVS), PVS modified with zinc oxide eugenol (ZOE) (PVSM), and an intraoral scanner (TRI) with a conventionally border-molded ZOE impression (control).

MATERIAL AND METHODS

Twelve edentulous maxillary impressions were made with the impression techniques. The analog impressions were scanned using a laboratory scanner, imported into 3-dimensional comparison software, and superimposed against the corresponding control. Trueness was evaluated by calculating the effective deviation known as root mean square (RMS) for the entire surface (ES) and for specific regions of interest such as peripheral border, inner seal, midpalatal suture, ridge, and posterior palatal seal. The secondary outcomes for this study were the patients' perception of the impression techniques. Statistical analyses with the Wilcoxon tests were carried out (α=.05).

RESULTS

For ES, significant differences were found when comparing ALG (1.21 ±0.35 mm) with PVS (0.75 ±0.17 mm; P=.008), PVSM (0.75 ±0.19 mm; P=.012), and TRI (0.70 ±0.18 mm; P=.006) but not among the other groups. Significant differences were found for peripheral border when comparing ALG (2.03 ±0.55 mm) with PVS (1.12 ±0.32 mm; P=.006), PVSM (1.05 ±0.29 mm; P=.003), and TRI (1.38 ±0.25 mm; P=.008), as well as TRI and PVSM (P=.028). Significant differences were also found for inner seal when comparing ALG (0.74 ±0.36 mm) with PVSM (0.52 ±0.13 mm; P=.041), as well as TRI (0.8 ±0.25 mm) versus PVS (0.56 ±0.14 mm; P=.005) and PVSM (P=.005). The difference at the ridge was significant when comparing PVS (0.18 ±0.07 mm) with PVSM (0.28 ±0.19 mm; P=.015) but not among the other groups. A significant difference was also found for posterior palatal seal when comparing PVS (0.55 ±0.41 mm) with PVSM (0.60 ±0.43 mm; P=.034). Patient perceptions showed significantly better satisfaction scores for ALG (1.83 ±2.03) and PVS (3.17 ±2.40) than for TRI (4.08 ±2.71), PVSM (4.58 ±2.35), and ZOE (6.83 ±1.75).

CONCLUSIONS

Edentulous impressions made with PVS, PVSM, and TRI had similar deviations and may yield clinically acceptable results. Irreversible hydrocolloids are contraindicated for definitive impression making in completely edentulous jaws.

摘要

问题陈述

简化的无牙颌印模技术已经流行起来,但其有效性尚未得到评估。

目的

本临床研究的目的是比较使用不可逆水胶体(ALG)、聚硅氧烷(PVS)、氧化锌丁香酚改性聚硅氧烷(ZOE)(PVSM)和口内扫描仪(TRI)制作上颌无牙颌印模的准确性,并与常规边缘模压 ZOE 印模(对照组)进行比较。

材料和方法

使用 12 个无牙上颌印模技术制作印模。模拟印模使用实验室扫描仪扫描,导入三维比较软件,并与相应的对照进行叠加。准确性通过计算整个表面(ES)和特定感兴趣区域(如周边边缘、内部密封、中腭缝、牙槽嵴和后腭密封)的有效偏差(称为均方根(RMS))来评估。本研究的次要结果是患者对印模技术的感知。使用 Wilcoxon 检验进行统计分析(α=.05)。

结果

对于 ES,当比较 ALG(1.21±0.35mm)与 PVS(0.75±0.17mm;P=.008)、PVSM(0.75±0.19mm;P=.012)和 TRI(0.70±0.18mm;P=.006)时,发现有显著差异,但在其他组之间没有差异。当比较 ALG(2.03±0.55mm)与 PVS(1.12±0.32mm;P=.006)、PVSM(1.05±0.29mm;P=.003)和 TRI(1.38±0.25mm;P=.008)时,以及 TRI 和 PVSM(P=.028)时,发现周边边缘有显著差异。当比较 ALG(0.74±0.36mm)与 PVSM(0.52±0.13mm;P=.041)以及 TRI(0.8±0.25mm)与 PVS(0.56±0.14mm;P=.005)和 PVSM(P=.005)时,发现内部密封也有显著差异。当比较 PVS(0.18±0.07mm)与 PVSM(0.28±0.19mm;P=.015)时,牙槽嵴的差异具有统计学意义,但在其他组之间没有差异。当比较 PVS(0.55±0.41mm)与 PVSM(0.60±0.43mm;P=.034)时,后腭密封也有显著差异。患者感知显示,ALG(1.83±2.03)和 PVS(3.17±2.40)的满意度评分明显高于 TRI(4.08±2.71)、PVSM(4.58±2.35)和 ZOE(6.83±1.75)。

结论

使用 PVS、PVSM 和 TRI 制作的无牙颌印模具有相似的偏差,可能产生临床可接受的结果。不可逆水胶体不适用于完全无牙颌的最终印模制作。

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