Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Clin Implant Dent Relat Res. 2022 Aug;24(4):424-434. doi: 10.1111/cid.13105. Epub 2022 Jun 15.
This study aimed to evaluate peri-implant tissue health and patient satisfaction of vertical and inclined posterior implants for mandibular bar overdentures.
Thirty edentulous participants received four implants in the interforaminal area of the mandible. The patients were randomly assigned into two equal groups; (1) vertical group (control): all implants were inserted vertically parallel to each other. Inclined group (study): the anterior implants were placed vertically, and the posterior implants were tilted 30° distally. Hader bar attachment with two 7 mm-distal cantilevers (vertical group) and without cantilevers (inclined group) was used to connect the implants to mandibular overdentures. Peri-implant tissue health (Plaque [PL] and gingival [GI] indices, pocket depth [PD], and crestal bone loss [CBL]) were evaluated after denture insertion (T0), 6 (T6), and 12 (T12) months after insertion. Patient satisfaction was evaluated using a visual analog scale after 12 months.
At T12, the vertical group showed significantly higher PL, PD, and CBL than the inclined group for anterior (p < 0.037) and posterior (p < 0.017) implants. The vertical group showed significantly higher GI than the inclined group for anterior implants (p = 0.003), and the inclined group showed significantly higher GI than the vertical group for posterior implants (p = 0.016). The inclined group showed significantly higher scores for general satisfaction (p = 0.049), prosthesis as a part of you (p = 0.013), appearance (p < 0.001), stability (p = 0.002), ease of cleaning (p < 0.001), and comfort (p = 0.001) than the vertical group.
Inclined posterior implants used to support mandibular bar overdentures are recommended than vertical implants, as it was associated with improved patient satisfaction and peri-implant tissue health.
本研究旨在评估下颌杆式覆盖义齿中垂直和倾斜后牙种植体的种植体周围组织健康和患者满意度。
30 名无牙颌患者在下颌骨的正中联合区植入 4 枚种植体。患者随机分为两组；（1）垂直组（对照组）：所有种植体相互平行垂直植入。倾斜组（实验组）：前牙垂直植入，后牙倾斜 30°远中。使用带有两个 7mm 远中悬臂的 Hader 杆连接种植体与下颌覆盖义齿（垂直组）和无悬臂（倾斜组）。义齿植入后即刻（T0）、植入后 6 个月（T6）和 12 个月（T12）时评估种植体周围组织健康（菌斑[PL]和牙龈[GI]指数、探诊深度[PD]和牙槽骨丧失[CBL]）。植入后 12 个月时使用视觉模拟量表评估患者满意度。
T12 时，垂直组前牙（p<0.037）和后牙（p<0.017）种植体的 PL、PD 和 CBL 显著高于倾斜组。垂直组前牙的 GI 显著高于倾斜组（p=0.003），而倾斜组后牙的 GI 显著高于垂直组（p=0.016）。倾斜组在总体满意度（p=0.049）、义齿作为你身体的一部分（p=0.013）、美观（p<0.001）、稳定性（p=0.002）、易于清洁（p<0.001）和舒适度（p=0.001）方面的评分显著高于垂直组。
与垂直种植体相比，倾斜后牙种植体用于支持下颌杆式覆盖义齿可获得更好的患者满意度和种植体周围组织健康。
