Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Alexandre Baraúna St. 949, Rodolfo Teófilo, Fortaleza, Ceará, Brazil.
Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Alexandre Baraúna St. 949, Rodolfo Teófilo, Fortaleza, Ceará, Brazil.
J Dent. 2020 Jul;98:103356. doi: 10.1016/j.jdent.2020.103356. Epub 2020 May 5.
To evaluate the effectiveness of CCDs produced by two impression procedures for the mandibular ridge, in patients with severe mandibular atrophy.
Fifty-two completely edentulous patients with severely resorbed mandibles were randomly allocated into two groups according to the impression procedure of the mandibular ridge: SI - single impression (stock tray and irreversible hydrocolloid); TI - two-step impression (custom tray, border molding with compound, and polyether). Assessments of oral health related quality of life (OHRQoL, primary outcome) and denture satisfaction were performed by using validated questionnaires. Denture quality was evaluated by means of functional tests.
Regardless of the technique, participants reported better OHRQoL (P < 0.001) in both follow-up periods (3 and 6 months after denture delivery), and groups resulted in similar OHIP-EDENT scores in its different domains (P > 0.05). Between-group differences were insignificant for general satisfaction (3 months, P = 0.699, 6 months, P = 0.392), as well as for aspects such as esthetics, comfort, mastication, speech, and prosthesis retention (P > 0.05). Overall clinical quality of the CCDs (P = 0.383) was similar between-group, as well as in specific aspects - interocclusal distance, occlusion, articulation, retention of the maxillary denture, and stability of both maxillary and mandibular dentures (P > 0.05).
Mandibular CCDs based on a single impression technique showed quality levels comparable to those generated by a two-step impression, both from the patient and clinician perspective.
A simplified impression technique which eliminates the secondary impression can provide CCDs of good clinical quality, which influences the OHRQoL, and satisfaction in the same extent they would by a two-step procedure, even for patients with severely reabsorbed mandibular ridges. (ClinicalTrials.gov: NCT02339194).
评估两种下颌牙槽嵴印模程序制作的种植覆盖义齿（CCD）在下颌严重萎缩患者中的有效性。
根据下颌牙槽嵴的印模程序，将 52 名下颌完全无牙且严重吸收的患者随机分为两组：SI-单印模（标准托盘和不可逆水胶体）；TI-两步印模（定制托盘、复合边缘成型和聚醚）。使用验证过的问卷评估口腔健康相关生活质量（OHRQoL，主要结局）和义齿满意度。通过功能测试评估义齿质量。
无论采用哪种技术，两组患者在义齿交付后 3 个月和 6 个月的两个随访期内，报告的 OHRQoL 均有所改善（P<0.001），并且 OHIP-EDENT 评分在不同领域的组间差异无统计学意义（P>0.05）。两组患者在总体满意度方面差异无统计学意义（3 个月时，P=0.699；6 个月时，P=0.392），以及在美观、舒适、咀嚼、言语和义齿固位等方面（P>0.05）。两组间 CCD 的总体临床质量（P=0.383）以及在特定方面——正中关系、正中关系位咬合、发音、上颌义齿固位以及上颌和下颌义齿稳定性（P>0.05）均相似。
基于单印模技术的下颌 CCD 从患者和临床医生的角度来看，其质量水平与两步印模技术相当。
一种简化的印模技术，消除了二次印模，可以提供临床质量良好的 CCD，其对 OHRQoL 和满意度的影响与两步法相同，即使是下颌牙槽嵴严重吸收的患者也是如此。（ClinicalTrials.gov：NCT02339194）。
