Faculty of Oral and Dental Medicine, Department of Prosthodontics, Future University in Egypt, Cairo, Egypt.
Faculty of Dentistry, Department of Prosthodontics, Ain Shams University, Cairo, Egypt.
J Prosthodont. 2023 Feb;32(2):162-169. doi: 10.1111/jopr.13516. Epub 2022 Apr 11.
PURPOSE: Primary retention and gradual loss of retention of different attachment systems are important key factors in proper attachment selection; however, studies on attachment retention show a wide range of retention values concerning the same attachment system. This in vitro study uses a novel approach that utilizes a digitally designed and 3D-printed reinforced overdenture, which has a digitally determined geometric center, in order to standardize results for future research and clinical work. This study aims to evaluate initial retention along with the gradual loss of retention at different time intervals between three types of stud attachments, retaining a digitally designed, reinforced mandibular overdenture after 5475 cycles simulating 5 years of attachment usage. MATERIALS AND METHODS: An epoxy model of an ACP Class I (American College of Prosthodontists) edentulous mandible was constructed. A fully computer-designed surgical guide was employed after virtual denture design to place two implants according to prosthetically driven implant placement protocol. A metal meshwork with tissue stops was designed digitally to reinforce the denture and to carry the geometric center. The meshwork was incorporated into the denture-intaglio surface, which was planned for attachment pickup. Forty-eight digitally designed and metal-reinforced 3D-printed dentures were divided into four groups (12 dentures for each group). Loss of retention was measured to compare two novel Locator attachments (12 pairs of Locator R-TX, 12 pairs of Locator F-TX medium and low retention, with 12 pairs of ball and socket). Each group was subjected to an insertion and removal fatigue test resembling 5 years of patient usage. Retention values were recorded using a universal testing machine. RESULTS: Locator F-TX medium and low retention showed loss of retention by 91.93% and 92.91%, after fatigue testing equivalent to 2 and 3 years of use, respectively. Ball and socket and Locator R-TX showed loss of retention by 19.87% and 26.31%, respectively, after fatigue testing equivalent to 5 years of use. CONCLUSIONS: Locator R-TX attachment systems showed promising retention for implant overdentures compared to ball and socket attachments. The proposed digital technique of denture reinforcement is capable of standardizing results for research and clinical work.
目的:不同附着体系统的初始固位和逐渐丧失固位是选择合适附着体的重要关键因素;然而,有关附着体固位的研究显示,对于同一附着体系统,其固位值存在很大差异。本体外研究采用一种新方法,利用数字化设计和 3D 打印增强的覆盖义齿,该义齿具有数字化确定的几何中心,以便为未来的研究和临床工作标准化结果。本研究旨在评估三种类型的种植体附着体在不同时间间隔的初始固位以及逐渐丧失固位的情况,同时在模拟 5 年附着体使用的 5475 个循环后保留数字化设计的增强下颌覆盖义齿。
材料和方法:构建了 ACP Ⅰ类(美国修复牙科学会)无牙颌的环氧模型。虚拟义齿设计后,采用全计算机设计的手术导板,根据修复驱动的种植体放置方案放置两个种植体。数字化设计了带有组织止动件的金属网格,以增强义齿并承载几何中心。将网格结合到义齿凹面中,计划用于附着体拾取。将 48 个数字化设计和金属增强的 3D 打印义齿分为四组(每组 12 个义齿)。比较了两种新型Locator 附着体(12 对Locator R-TX、12 对Locator F-TX 中低保留和 12 对球窝)的固位力损失。每组都进行了类似于患者使用 5 年的插入和取出疲劳测试。使用万能试验机记录保留值。
结果:Locator F-TX 中低保留在疲劳测试相当于使用 2 年和 3 年后,保留损失分别为 91.93%和 92.91%。球窝和 Locator R-TX 在疲劳测试相当于使用 5 年后,保留损失分别为 19.87%和 26.31%。
结论:与球窝附着体相比,Locator R-TX 附着体系统对种植覆盖义齿具有良好的固位效果。义齿增强的数字化技术能够为研究和临床工作标准化结果。
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