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常规与 CAD-CAM 方案制作全口义齿的非计划性、后期调整就诊比较:一项临床研究。

Comparison of nonscheduled, postinsertion adjustment visits for complete dentures fabricated with conventional and CAD-CAM protocols: A clinical study.

机构信息

Prosthodontist, Gundersen Health System, LaCrosse, Wis; Adjunct Associate Professor, Graduate Prosthodontics, Marquette University School of Dentistry, Milwaukee, Wis.

Biostatistician, Gundersen Lutheran Medical Foundation, LaCrosse, Wis.

出版信息

J Prosthet Dent. 2019 Nov;122(5):459-466. doi: 10.1016/j.prosdent.2018.10.030. Epub 2019 Jun 12.

Abstract

STATEMENT OF PROBLEM

Unscheduled denture-adjustment visits may disrupt both patients and clinicians. Denture-adjustment visits have not been correlated with denture-processing methods.

PURPOSE

The purpose of this clinical study was to identify differences in the number of unscheduled postinsertion-adjustment visits of patients with complete dentures fabricated by injection molding (IM) versus dentures fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM).

MATERIAL AND METHODS

One hundred six participants were evaluated in the study. They were consecutively treated in a private practice setting and followed up for 1 year after the insertion of new complete dentures. The first 33 received dentures fabricated using an IM system, and the other 73 were milled using a CAD-CAM system. All participants had been edentulous for at least 1 year. Participant ages ranged from 29 to 83 years. IM dentures were fabricated by a commercial dental laboratory; CAD-CAM dentures were milled by a commercial manufacturer. All participants were scheduled for 1- or 2-week postinsertion office visits. Further adjustment visits were scheduled according to participant request. The results were tabulated, and univariable tests of association were performed including chi-square and the Fisher exact tests for categorical comparisons and the Wilcoxon rank sum test for comparison of ordinal continuous data. A multivariable logistic regression model was used to control for the influence of multiple predictor variables on the outcome of interest.

RESULTS

Edentulous years ranged from 1 to 60. Approximately one half (n=56) of all participants returned for scheduled postinsertion visits approximately 1 to 2 weeks after insertion of the dentures. No significant demographic or clinical differences were noted between participants receiving CAD-CAM or conventional dentures. Return visits for unscheduled adjustments were not associated with the method of denture fabrication or any other demographic features (P=.55).

CONCLUSIONS

Based on the results of this study, there were no significant differences in the number of unscheduled, postinsertion visits for participants whose dentures were fabricated following IM or CAD-CAM milling protocols. Clinicians may choose to fabricate complete dentures with either protocol and expect similar clinical results in terms of the number of unscheduled postinsertion visits.

摘要

问题陈述

非计划性义齿调整就诊可能会干扰患者和临床医生。义齿调整就诊与义齿加工方法尚未相关联。

目的

本临床研究的目的是确定通过注塑成型(IM)与计算机辅助设计和计算机辅助制造(CAD-CAM)制造的全口义齿患者的非计划性义齿修复后调整就诊次数的差异。

材料和方法

本研究共评估了 106 名参与者。他们在一家私人诊所中连续接受治疗,并在新全口义齿插入后随访 1 年。前 33 名接受了使用 IM 系统制造的义齿,其余 73 名接受了 CAD-CAM 系统制造的义齿。所有参与者都至少有 1 年无牙颌病史。参与者年龄在 29 至 83 岁之间。IM 义齿由商业牙科实验室制造;CAD-CAM 义齿由商业制造商铣削。所有参与者均安排在插入后 1 或 2 周进行门诊随访。根据患者的要求安排进一步的调整就诊。结果进行了制表,并进行了关联的单变量检验,包括卡方检验和 Fisher 确切检验用于分类比较,Wilcoxon 秩和检验用于比较有序连续数据。使用多变量逻辑回归模型控制多个预测变量对感兴趣的结果的影响。

结果

无牙颌年限为 1 至 60 年。所有参与者中约有一半(n=56)在义齿插入后约 1 至 2 周内返回进行了计划的插入后就诊。接受 CAD-CAM 或传统义齿的参与者之间没有明显的人口统计学或临床差异。非计划性调整就诊与义齿制造方法或任何其他人口统计学特征无关(P=.55)。

结论

根据本研究的结果,通过 IM 或 CAD-CAM 铣削方案制造义齿的患者的非计划性义齿修复后就诊次数没有显著差异。临床医生可以选择使用任何一种方案来制作全口义齿,并期望在非计划性义齿修复后就诊次数方面获得相似的临床效果。

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