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上颌种植覆盖义齿通过四个无夹板附着体固位,与天然牙或固定义齿咬合:一年临床结果。

Maxillary implant overdenture retained by four unsplinted attachments and opposed by a natural or fixed dentition: One-year clinical outcomes.

机构信息

Department of Removable Prosthodontics, University of Liège, Liège, Belgium.

Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liège, Belgium.

出版信息

Clin Oral Implants Res. 2020 Aug;31(8):747-767. doi: 10.1111/clr.13623. Epub 2020 Jun 30.

Abstract

OBJECTIVES

The aim of this prospective study was to evaluate the implant, prosthesis, and patient-reported outcomes of maxillary removable prostheses retained by 4 implant-supported study abutments after a follow-up period of 1 year in patients with natural teeth or a fixed rehabilitation in the mandible.

MATERIALS AND METHODS

A total of 30 patients were included, and all received 4 implants in the upper maxilla. After 12 weeks, the prostheses were connected to the implant with unsplinted attachments. The implant and prosthodontics outcomes were assessed over a follow-up period of 1 year. Patient-reported outcome measures (PROMs) were evaluated with the Oral Health Impact Profile (OHIP-20) questionnaire and an adaptation of the McGill Denture Satisfaction Instrument using a visual analogue scale (VAS).

RESULTS

A single patient dropped out. At the post-operative 12-week follow-up, 79.3% (95% CI: 64.6%-94.1%) of the patients displayed peri-implant mucosa hyperplasia and 69.0% (95% CI: 52.1%-85.8%) showed pain. After 1 year, 16 implants failed in 10 patients, leading to an implant survival rate of 86.2% (95% CI: 79.0%-92.5%), and the mean peri-implant bone loss was 1.01 ± 0.77 mm (95% CI: 0.85-1.16 mm). The prosthesis survival rate was 96.6% (95% CI: 82.2%-99.9%). The OHIP-20 and VAS scores both improved significantly from baseline to 1 year (p < .001).

CONCLUSION

The implant survival rate was lower compared to the literature for the upper maxilla. Despite the encountered problems, PROMs showed significant improvement with the implant overdenture retained by 4 unsplinted implants compared to conventional dentures.

摘要

目的

本前瞻性研究旨在评估在上颌使用 4 个种植体支持的研究基台固位的可摘局部义齿在 1 年随访期内的种植体、修复体和患者报告的结果,这些患者的下颌有天然牙或固定修复体。

材料和方法

共纳入 30 名患者,所有患者在上颌均植入 4 个种植体。12 周后,使用无夹板附着体将义齿连接到种植体上。在 1 年的随访期内,评估种植体和修复体的结果。使用口腔健康影响量表(OHIP-20)问卷和改良的麦吉尔义齿满意度量表(VAS)评估患者报告的结果(PROMs)。

结果

1 名患者失访。在术后 12 周随访时,79.3%(95%可信区间:64.6%-94.1%)的患者出现种植体周围黏膜增生,69.0%(95%可信区间:52.1%-85.8%)的患者出现疼痛。1 年后,10 名患者中有 16 个种植体失败,导致种植体存活率为 86.2%(95%可信区间:79.0%-92.5%),种植体周围骨平均损失为 1.01±0.77mm(95%可信区间:0.85-1.16mm)。义齿存活率为 96.6%(95%可信区间:82.2%-99.9%)。OHIP-20 和 VAS 评分均从基线显著改善至 1 年(p<0.001)。

结论

与上颌的文献相比,该研究的种植体存活率较低。尽管存在问题,但与传统义齿相比,使用 4 个无夹板种植体固位的种植覆盖义齿的 PROMs 显著改善。

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