Arat Bilhan Selda, Geckili Onur, Cilingir Altug, Bozdag Ergun, Bilhan Hakan
Private Office, Waltrop, Germany.
Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
J Korean Assoc Oral Maxillofac Surg. 2019 Aug;45(4):199-206. doi: 10.5125/jkaoms.2019.45.4.199. Epub 2019 Aug 28.
In mandibular edentulism, the treatment option with a two-interforaminal implant-retained bridge and a removable partial denture is rarely evaluated in literature. The aim of this study was to evaluate the stress distribution of this treatment option by comparing it with traditional treatment options with interforaminal implants in the edentulous mandible.
Two interforaminal implants were placed in a formalin-fixed cadaver mandible, and overdentures with three different types of attachments were fabricated: (1) two ball attachments and an overdenture, (2) a Dolder bar and an overdenture, and (3) screw-retained two-implant inter-canine porcelain fused to a metal bridge and an implant-assisted removable denture (IARD) with precision attachments. Three biting conditions were generated for each denture type, and the strains were documented under vertical loading of 100 N.
The calculated strain values from measured strains in all measurement sites and loading conditions for the screw-retained two-implant inter-canine porcelain fused to a metal bridge and a cast framework partial denture with precision attachments situation were lower than in the other scenarios (<0.05).
Within the limitations of the present study, it can be concluded that an IARD may be a reasonable and valuable alternative to ball attachments or a bar in two interforaminal implants, especially when the patients prefer to be able to show their teeth even when they take out their removable dentures.
在下颌无牙颌中，文献中很少评估双孔间种植体支持式桥与可摘局部义齿这种治疗方案。本研究的目的是通过将这种治疗方案与无牙颌下颌中采用孔间种植体的传统治疗方案进行比较，来评估其应力分布情况。
在一具经福尔马林固定的尸体下颌骨中植入两颗孔间种植体，并制作带有三种不同类型附着体的覆盖义齿：(1)两个球帽附着体和一个覆盖义齿；(2)一个Dolder杆和一个覆盖义齿；(3)螺丝固位的双种植体间尖牙区金属烤瓷桥以及带有精密附着体的种植辅助可摘义齿（IARD）。每种义齿类型设置三种咬合情况，并记录在100 N垂直加载下的应变。
在所有测量部位和加载条件下，对于螺丝固位的双种植体间尖牙区金属烤瓷桥以及带有精密附着体的铸造支架局部义齿这种情况，由测量应变计算得出的应变值低于其他情况（<0.05）。
在本研究的局限性范围内，可以得出结论，IARD可能是双孔间种植体上球帽附着体或杆附着体的一种合理且有价值的替代方案，特别是当患者即使在取下可摘义齿时也希望能够露出牙齿的情况下。
