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无支架种植体固位上颌覆盖义齿的回顾性队列分析。

Retrospective cohort analysis of maxillary overdentures retained by unsplinted implants.

机构信息

Assistant Professor, Clinical Restorative Dentistry, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Penn.

Private practice, Mobile, Ala; and Adjunct Assistant Professor, Department of Prosthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC.

出版信息

J Prosthet Dent. 2019 Sep;122(3):301-308.e1. doi: 10.1016/j.prosdent.2018.10.014. Epub 2019 Apr 1.

Abstract

STATEMENT OF PROBLEM

Implant therapy involving an unsplinted 2-implant-retained overdenture is well defined as a successful treatment for a patient with an edentulous mandible. However, a similar unsplinted implant therapy supporting a maxillary overdenture is not well characterized.

PURPOSE

The purpose of this retrospective study was to evaluate maxillary overdentures retained by 4 unsplinted implants measuring implant survival, overdenture survival, and patient-reported outcomes.

MATERIAL AND METHODS

Participants who had received an unsplinted implant-retained maxillary overdenture were included in the study. Participants presented for one denture recall appointment, during which comprehensive examination, including radiographs, was performed and clinical findings were recorded. Participants also completed the Oral Health Impact Profile-49 (OHIP-49) and a 20-item visual analog scale (VAS) satisfaction questionnaire. Nonparametric statistical tests were used to compare OHIP-49 and VAS scores across age, sex, time since overdenture insertion, mandibular dental status, smoking status, maxillary mucosal health, and overdenture hygiene.

RESULTS

For the 44 participants, 3 of 4 implants failed in 1 individual. The cumulative implant survival rate was 98% (97.7% patient level). No prosthetic failures (that is, overdenture replacement) occurred, indicating a 100% prosthesis survival rate. The mean ±standard deviation OHIP-49 severity score was 23.6 ±26.0, and the mean ±standard deviation total VAS score was 179.2 ±29.4. Increased age was associated with lower OHIP-49 severity score (P=.036), and participants with unhealthy oral mucosa or denture stomatitis demonstrated significantly higher OHIP-49 severity scores (P=.003).

CONCLUSIONS

In this retrospective evaluation, unsplinted implant-retained maxillary overdenture therapy was associated with high implant and prosthetic survival, as well as high patient satisfaction and quality of life. Age, sex, maxillary mucosal health, and mandibular dental status resulted in significant differences with respect to oral health-related quality of life and patient satisfaction, indicating that this treatment option may be ideal for certain patients.

摘要

问题陈述

无夹板 2 种植体固位覆盖义齿的种植体治疗被明确为下颌无牙颌患者的成功治疗方法。然而,类似的无夹板种植体治疗支持上颌覆盖义齿的情况并不明确。

目的

本回顾性研究的目的是评估由 4 个无夹板种植体支撑的上颌覆盖义齿的种植体存活率、覆盖义齿存活率和患者报告的结果。

材料和方法

纳入研究的参与者接受了无夹板种植体固位的上颌覆盖义齿。参与者在一次义齿复查时就诊,在此期间进行了全面检查,包括影像学检查,并记录了临床发现。参与者还完成了口腔健康影响程度量表-49(OHIP-49)和 20 项视觉模拟量表(VAS)满意度问卷。非参数统计检验用于比较年龄、性别、覆盖义齿插入时间、下颌牙齿状况、吸烟状况、上颌黏膜健康状况和覆盖义齿卫生状况对 OHIP-49 和 VAS 评分的影响。

结果

对于 44 名参与者,有 1 名个体的 3 个种植体失败。累积种植体存活率为 98%(患者水平为 97.7%)。未发生修复体失败(即覆盖义齿更换),表明修复体存活率为 100%。平均±标准差 OHIP-49 严重程度评分为 23.6±26.0,平均±标准差总 VAS 评分为 179.2±29.4。年龄较大与 OHIP-49 严重程度评分较低相关(P=.036),口腔黏膜不健康或义齿口炎的参与者 OHIP-49 严重程度评分显著较高(P=.003)。

结论

在这项回顾性评估中,无夹板种植体固位上颌覆盖义齿治疗与高种植体和修复体存活率以及高患者满意度和生活质量相关。年龄、性别、上颌黏膜健康状况和下颌牙齿状况对口腔健康相关生活质量和患者满意度有显著影响,表明这种治疗选择可能对某些患者较为理想。

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