Şirin Sarıbal Gamze, Ersu Nihal, Canger Emin Murat
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, 38039, Kayseri, Turkey.
Clin Oral Investig. 2022 Sep;26(9):5643-5652. doi: 10.1007/s00784-022-04519-5. Epub 2022 Apr 30.
The aim of this study was to compare the changes in mandibular bone structure in edentulous patients who were rehabilitated with conventional complete dentures (CCD) and implant supported overdentures (ISO), by evaluating alveolar bone loss (ABL), panoramic mandibular index (PMI), mandibular cortical width (MCW), gonion index (GI), antegonial index (AI), and articular eminence inclination (AEI).
Panoramic radiographs of 63 edentulous patients using CCD, 63 edentulous patients using ISO, and 126 patients without tooth loss were evaluated. Edentulous patients had a 2-year and 6-year follow-up panoramic radiograph image. ABL (anterior, premolar, and molar regions), MCW, PMI, AI, GI, and AEI were measured in each patient. Variation between measurements was analyzed using repeated measures ANOVA test and post hoc Tukey test.
Both edentulous groups showed significantly lower mean than without tooth lost group in all measures (p < 0.000). ISO group showed significantly lower mean ABL than CCD group in anterior (p = 0.000), right premolar (p = 0.005), left premolar (p = 0.005), right molar (p < 0.000), and left premolar (p < 0.000) regions in short term. ISO group showed significantly lower mean ABL than CCD group in anterior (p = 0.021), right molar (p < 0.000), and left premolar (p < 0.000) regions in long-term. There is no statistically significant difference between the CCD and ISO groups in right premolar (p = 0.200) and left premolar (p = 0.134) regions in long term. Both edentulous groups showed significantly lower mean MCW (p < 0.000), PMI (p < 0.000), AI (p < 0.000), GI (p < 0.012), and AEI (p < 0.002) than the without tooth loss group. There is no statistically significant difference between the CCD and ISO groups in terms of changes in the mean MCW, PMI, AI, GI, and AEI measurement in short and long term (p > 0.000).
In the short and long term, edentulism reduced alveolar crest height, MCW, and AEI in individuals, but had no effect on PMI, AI, or GI. The use of prosthesis did not prevent the decrease of alveolar crest height, MCW, or AEI (CCP or ISO). In the short and long term, however, ISO created less ABL in the mandibular anterior and molar regions than CCD.
ABL cannot be halted in edentulous people, but by using ISO instead of CCD for rehabilitation, resorption can be reduced.
本研究旨在通过评估牙槽骨吸收（ABL）、全口下颌骨指数（PMI）、下颌骨皮质宽度（MCW）、下颌角指数（GI）、下颌角前切迹指数（AI）和关节结节斜度（AEI），比较使用传统全口义齿（CCD）和种植体支持覆盖义齿（ISO）修复的无牙颌患者下颌骨结构的变化。
对63例使用CCD的无牙颌患者、63例使用ISO的无牙颌患者以及126例无牙缺失患者的全景X线片进行评估。无牙颌患者有2年和6年的随访全景X线片图像。测量每位患者的ABL（前部、前磨牙区和磨牙区）、MCW、PMI、AI、GI和AEI。使用重复测量方差分析和事后Tukey检验分析测量值之间的差异。
两个无牙颌组在所有测量指标上的平均值均显著低于无牙缺失组（p < 0.000）。短期内，ISO组在前部（p = 0.000）、右侧前磨牙（p = 0.005）、左侧前磨牙（p = 0.005）、右侧磨牙（p < 0.000）和左侧前磨牙（p < 0.000）区域的平均ABL显著低于CCD组。长期来看，ISO组在前部（p = 0.021）、右侧磨牙（p < 0.000）和左侧前磨牙（p < 0.000）区域的平均ABL显著低于CCD组。长期来看，CCD组和ISO组在右侧前磨牙（p = 0.200）和左侧前磨牙（p = 0.134）区域无统计学显著差异。两个无牙颌组的平均MCW（p < 0.000）、PMI（p < 0.000）、AI（p < 0.000）、GI（p < 0.012）和AEI（p < 0.002）均显著低于无牙缺失组。CCD组和ISO组在短期和长期的平均MCW、PMI、AI、GI和AEI测量变化方面无统计学显著差异（p > 0.000）。
短期和长期来看，无牙颌会降低个体的牙槽嵴高度、MCW和AEI，但对PMI、AI或GI无影响。使用修复体并不能阻止牙槽嵴高度、MCW或AEI的降低（CCD或ISO）。然而，短期和长期来看，ISO在下颌前部和磨牙区造成的ABL比CCD少。
无牙颌患者的ABL无法停止，但通过使用ISO而非CCD进行修复，可以减少吸收。
