Zhou Ting, Mirchandani Bharat, Li Xing-Xing, Mekcha Pichaya, Buranawat Borvornwut
Department of Orthodontics, School of Stomatology, Kunming Medical University, Yunnan, PR China.
Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand.
Acta Odontol Scand. 2023 Jan;81(1):1-17. doi: 10.1080/00016357.2022.2077980. Epub 2022 May 26.
The aims of this systematic review were to evaluate the clinical masticatory performance of implant-supported restorations, observe the occlusal force changes in the distribution of the implant restoration and reveal the positive and negative contributing factors of implant design and components based on the outcomes of digital occlusal measurement.
An extensive search was conducted through PubMed and CENTRAL to identify clinical trials on implant-retained restorations using digital occlusal analysis methods. Two researchers assessed the identified studies and data extraction independently, and the data synthesis strategies without meta-analysis that summarizes the effect estimates were adopted.
The search screened 3821 titles and abstracts, then full-text analysis for 26 articles was performed, and 14 studies were included in the quantitative synthesis. Four of six studies for implant-retained overdenture showed statistically significant improved bite force when immediate loading ( = .00045, .00005, .00055, and .00005, respectively), and no statistically significant results in the other two studies ( = .225, .371, respectively.) However, the results of the favoured intervention were not statistically significant ( = .104, .166, respectively) in two studies of single posterior implant restorations. In all three studies, the bite force distributed on the implant prostheses of partially fixed implant-retained restoration increased statistically significantly ( = .013, .001, .05, respectively).
The edentulous restoration supported by implants seems to significantly improves bite force and chewing efficiency compared with conventional dentures. Regular quantitative occlusal measurement is recommended to avoid the possible risk of overload. Smaller implants size and relatively small and flexible attachment designs may be more conducive to the stability and retention of the restoration of atrophy of alveolar bone.
本系统评价旨在评估种植体支持修复体的临床咀嚼性能,观察种植修复体受力分布中的咬合力变化,并基于数字咬合测量结果揭示种植体设计及部件的正负相关影响因素。
通过PubMed和CENTRAL进行广泛检索,以识别采用数字咬合分析方法的种植体固位修复体的临床试验。两名研究人员独立评估所识别的研究并进行数据提取,采用无Meta分析的数据合成策略汇总效应估计值。
检索筛选出3821篇标题和摘要,随后对26篇文章进行全文分析,14项研究纳入定量合成。六项种植体固位覆盖义齿研究中有四项显示即刻加载时咬合力有统计学显著改善(分别为P = 0.00045、0.00005、0.00055和0.00005),另外两项研究无统计学显著结果(分别为P = 0.225、0.371)。然而,在两项单颗后牙种植修复体研究中,优势干预的结果无统计学显著差异(分别为P = 0.104、0.166)。在所有三项研究中,部分固定种植体固位修复体的种植体假体上分布的咬合力有统计学显著增加(分别为P = 0.013、0.001、0.05)。
与传统义齿相比,种植体支持的无牙颌修复似乎能显著提高咬合力和咀嚼效率。建议定期进行定量咬合测量以避免可能的过载风险。较小的种植体尺寸以及相对小且灵活的附着设计可能更有利于牙槽骨萎缩患者修复体的稳定性和固位。