Seelig da Cunha Kael, De Lima Coltro Maria Paula, Drummond Luis Gustavo, Ozkomur Ahmet, Villarinho Eduardo Aydos, Teixeira Eduardo Rolim, Vigo Álvaro, Shinkai Rosemary S A
Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil.
Private practice, Montenegro, Brazil.
J Prosthodont Res. 2023 Apr 12;67(2):173-179. doi: 10.2186/jpr.JPR_D_21_00254. Epub 2022 May 26.
Implant-supported fixed complete dentures (IFCD) experience failures and complications related to biological and technical risk factors. This study investigated the effect of biomechanical variables of IFCD on 1-year peri-implant bone loss at the buccal, palatal/lingual, mesial, and distal implant sides. A new method was used to measure the geometric biomechanical variables of IFCD using cone beam computed tomography (CBCT).
The study sample consisted of 246 external hexagon implants supporting 48 hybrid IFCD in 44 patients. CBCT images obtained immediately (T0) and 1 year (T1) after prosthesis installation were used to measure the support polygon area, clinical crown/implant (C/I) ratio (vertical lever), anteroposterior power and resistance arms, anterior and posterior cantilevers (horizontal levers), and peri-implant bone remodeling (T1-T0). Data were analyzed using multilevel multivariable models.
The average total bone loss in the mandible and maxilla were 0.88 mm, with a loss of 0.62 mm in the mandible and 1.08 mm in the maxilla. The C/I ratio had a significant effect on bone loss on the mesial, distal, and palatal/lingual sides (P <.05). The anterior cantilever had a protective effect on the lingual side of the anterior implant. No effect on bone loss was found for the support polygon area, posterior cantilever, resistance arm, or power arm (P >.05).
The results suggest that the C/I ratio and anterior cantilever in IFCD affect peri-implant bone loss according to the implant side and position in the arch.
种植体支持的固定全口义齿（IFCD）会经历与生物和技术风险因素相关的失败和并发症。本研究调查了IFCD的生物力学变量对种植体颊侧、腭侧/舌侧、近中侧和远中侧1年种植体周围骨丢失的影响。使用一种新方法，通过锥形束计算机断层扫描（CBCT）测量IFCD的几何生物力学变量。
研究样本包括44例患者中支持48副混合式IFCD的246颗外六角种植体。在义齿安装后立即（T0）和1年（T1）获得的CBCT图像用于测量支持多边形面积、临床冠/种植体（C/I）比率（垂直杠杆）、前后动力臂和阻力臂、前后悬臂（水平杠杆）以及种植体周围骨重塑（T1 - T0）。数据使用多水平多变量模型进行分析。
下颌骨和上颌骨的平均总骨丢失量为0.88mm，下颌骨骨丢失量为0.62mm，上颌骨为1.08mm。C/I比率对近中侧、远中侧和腭侧/舌侧的骨丢失有显著影响（P <.05）。前悬臂对前部种植体的舌侧有保护作用。未发现支持多边形面积、后悬臂、阻力臂或动力臂对骨丢失有影响（P >.05）。
结果表明，IFCD中的C/I比率和前悬臂根据种植体在牙弓中的位置和种植体侧面影响种植体周围骨丢失。
