Int J Oral Maxillofac Implants. 2021 Mar-Apr;36(2):346-354. doi: 10.11607/jomi.8472.
This study aimed to examine clinical and patient-centered outcomes of resilient stud and stress-free bar attachments used for immediately loaded implants supporting mandibular overdentures.
Thirty edentulous patients with sufficient bone mesial and distal to the mental foramen received new dentures. The patients were randomly assigned into two groups. After 3 months of adaptation, four implants were placed in the canine and second premolar areas of the mandible using computer-guided surgery and the flapless surgical approach. Overdentures were connected immediately to the implants using either resilient stud (Locator) or stress-free implant bar (SFI-Bar) attachments. Marginal resorption of bone, plaque and gingival indices, pocket depth, and implant stability were evaluated for both groups at baseline (prosthesis delivery) and 6 and 12 months thereafter. Implant survival and patient satisfaction were calculated after 12 months.
For both groups, marginal bone loss (P < .043), plaque scores (P < .001), and probing depth (P < .002) increased significantly with time. SFI-Bar recorded lower marginal bone loss (P = .048) and higher plaque scores (P = .021) and probing depth (P = .001) than Locator after 12 months of denture insertion. The implant survival was 96.6% and 98.3% for Locator and SFI-Bar, respectively. No significant difference was found in the survival rate between groups (P = .56). Locator showed significantly higher general satisfaction, satisfaction with retention, comfort, and cleaning of overdentures compared with SFI-Bar (P < .001).
Within the limits of this investigation, both resilient stud and stress-free bar attachments can be used successfully with mandibular four-implant overdentures subjected to an immediate loading protocol. However, studs may be preferred regarding peri-implant soft tissue health, patient satisfaction with retention, cleaning, and comfort, and stress-free bar attachments could be more effective in terms of marginal bone preservation.
本研究旨在检查使用弹性固位体和无应力杆附着体即刻加载种植体支持下颌覆盖义齿的临床和以患者为中心的结果。
30 名牙槽嵴骨量充足的无牙颌患者（颏孔近远中均有足够的骨量）接受了新的义齿。患者随机分为两组。在适应 3 个月后，使用计算机引导手术和无瓣手术方法在下颌的犬齿和第二前磨牙区域植入四颗种植体。使用弹性固位体（Locator）或无应力种植体杆（SFI-Bar）附着体将覆盖义齿即刻连接到种植体上。在基线（义齿交付）和之后的 6 个月和 12 个月，评估两组的骨边缘吸收、菌斑和牙龈指数、探诊深度和种植体稳定性。在 12 个月后计算种植体存活率和患者满意度。
对于两组，边缘骨丢失（P<.043）、菌斑评分（P<.001）和探诊深度（P<.002）随时间显著增加。SFI-Bar 记录的边缘骨丢失（P=.048）、菌斑评分（P=.021）和探诊深度（P=.001）在义齿插入 12 个月后均低于 Locator。Locator 和 SFI-Bar 的种植体存活率分别为 96.6%和 98.3%。两组间的存活率无显著差异（P=.56）。Locator 在保留、舒适度和义齿清洁方面的总体满意度明显高于 SFI-Bar（P<.001）。
在本研究范围内，弹性固位体和无应力杆附着体均可成功用于下颌四种植体覆盖义齿，采用即刻加载方案。然而，在种植体周围软组织健康、患者对保留、清洁和舒适的满意度方面，固位体可能更具优势，而在边缘骨保存方面，无应力杆附着体可能更有效。
