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临床结果和成本的传统和数字全口义齿在大学诊所:回顾性研究。

Clinical outcomes and costs of conventional and digital complete dentures in a university clinic: A retrospective study.

机构信息

Assistant Professor, Comprehensive Dental Care Unit, The Nippon Dental University Niigata Hospital, Niigata, Japan.

Specialization Candidate, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.

出版信息

J Prosthet Dent. 2022 Sep;128(3):390-395. doi: 10.1016/j.prosdent.2020.12.014. Epub 2021 Feb 18.

DOI:10.1016/j.prosdent.2020.12.014
PMID:33610329
Abstract

STATEMENT OF PROBLEM

Scientific data analyzing the clinical outcomes and costs of complete dentures fabricated by using conventional and computer-aided design and computer-aided manufacturing (CAD-CAM) processes are lacking.

PURPOSE

The purpose of this retrospective study was to compare the treatment duration, financial costs, and postdelivery adjustments of CAD-CAM and conventional removable complete dentures.

MATERIAL AND METHODS

Thirty-two edentulous participants (16 women, 16 men; age 35-85 years) who had received either CAD-CAM (n=16) or conventional (n=16) maxillary and mandibular removable complete dentures provided by prosthodontists with a minimum of 2 years of experience were evaluated. The CAD-CAM denture systems were either DDS-AV (AvaDent Digital Dental Solutions) (n=11) or DD-IV (Wieland Digital Denture) (n=5). The total treatment period (days) was recorded at 3 different time points (T0: preliminary alginate impression; T1: denture delivery; T2: last scheduled postdelivery adjustment). Adjustments during the follow-up (after T2) were noted and included the removal of areas of excessive pressure, relining, or repairs. The costs of the dental treatment and the laboratory fees were calculated. The Wilcoxon rank sum tests were used for statistical analysis (α=.05).

RESULTS

No statistically significant difference regarding the treatment duration between digitally and conventionally fabricated removable complete dentures was found: T-T (P=.889); T-T (P=.675); T- T (P=.978). No significant difference was found in the number adjustments for areas of excessive pressure, relines, or repairs (P=.757, P=1.000, P=1.000) during the period. Laboratory costs of CAD-CAM removable complete dentures were significantly lower than those of conventional removable complete dentures (P<.001), but clinical fees were similar between groups (P=.596), resulting in a reduction in the overall total costs for the CAD-CAM removable complete dentures (P=.011). Regarding the number of clinical visits, neither the group (conventional/CAD-CAM (P=.945)/DDS-AV/DD-IV [P=.848]) nor the interaction group (conventional/CAD-CAM and DDS-AV/DD-IV)/period (P=.084/P=.171) showed any significant differences.

CONCLUSIONS

CAD-CAM removable complete dentures can be considered a viable alternative to conventional removable complete dentures regarding treatment duration, clinical and follow-up visits, adjustments, and maintenance requirements.

摘要

问题陈述

缺乏使用传统和计算机辅助设计与计算机辅助制造(CAD-CAM)工艺制作全口义齿的临床结果和成本的科学数据分析。

目的

本回顾性研究的目的是比较 CAD-CAM 和传统可摘全口义齿的治疗时间、财务成本和交付后调整。

材料与方法

32 名无牙颌参与者(16 名女性,16 名男性;年龄 35-85 岁)接受了由具有至少 2 年经验的修复科医生制作的 CAD-CAM(n=16)或传统(n=16)上颌和下颌可摘全口义齿。CAD-CAM 义齿系统为 DDS-AV(AvaDent Digital Dental Solutions)(n=11)或 DD-IV(Wieland Digital Denture)(n=5)。在 3 个不同时间点(T0:初步藻酸盐印象;T1:义齿交付;T2:最后一次预定交付后调整)记录总治疗期(天)。在随访期间(T2 后)记录了调整情况,包括去除过度压力区域、衬里或修复。计算了牙科治疗和实验室费用。使用 Wilcoxon 秩和检验进行统计分析(α=.05)。

结果

数字化和传统制作的可摘全口义齿在治疗时间方面无统计学差异:T-T(P=.889);T-T(P=.675);T-T(P=.978)。在交付期间,过度压力区域、衬里或修复的调整次数无显著差异(P=.757,P=1.000,P=1.000)。CAD-CAM 可摘全口义齿的实验室成本明显低于传统可摘全口义齿(P<.001),但两组的临床费用相似(P=.596),导致 CAD-CAM 可摘全口义齿的总费用降低(P=.011)。关于临床就诊次数,组(传统/CAD-CAM(P=.945)/DDS-AV/DD-IV(P=.848))和组间交互(传统/CAD-CAM 和 DDS-AV/DD-IV)/期间(P=.084/P=.171)均无显著差异。

结论

CAD-CAM 可摘全口义齿在治疗时间、临床和随访就诊、调整和维护要求方面可被视为传统可摘全口义齿的可行替代方案。

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