Wendler Frank, Diehl Lisa, Shayanfard Pejman, Karl Matthias
Institute of Materials Simulation, Department of Materials Science, Friedrich-Alexander University Erlangen-Nürnberg, 90762 Fürth, Germany.
Department of Prosthodontics, Saarland University, 66421 Homburg, Germany.
J Clin Med. 2023 Jan 28;12(3):1012. doi: 10.3390/jcm12031012.
Numerous attachment systems exist for implant-supported overdentures, with each having specific limitations in terms of retention, cost, wear, maintenance and cleanability. A retrospective analysis of patients restored with implant-supported overdentures using bars, telescopic crowns and Locator-type attachments was performed and the patients were interviewed. An in vitro strain gauge study compared telescopic crowns, Locator-type attachments and a novel flexible attachment system employing a shape memory alloy (NiTi) with respect to peri-implant strain development during insertion, loading and removal of an overdenture. A significantly lower number of attachment-related complications was observed in bars as compared to telescopic crowns ( = 0.00007) and Locator-type attachments ( = 0.00000), respectively. Greater overall patient satisfaction was noted in bar-retained restorations while Locator-type attachments led to lower levels of satisfaction regarding prosthesis retention. In vitro, telescopic crowns caused maximum strain development during prosthesis insertion and loading, while during removal this was observed in Locators with white retentive inserts. NiTi attachments caused significantly lower strain development during insertion as compared to telescopic crowns ( = 0.027). During loading, NiTi attachments caused significantly lower strain development than Locators with blue retentive inserts ( = 0.039). During removal, NiTi attachments caused significantly less strain development as compared to Locators with white retentive inserts ( = 0.027). Positional discrepancies between male and female attachment parts affected the retention and reaction force between both components, which may be minimized by using the novel NiTi attachment system. This may be beneficial in terms of component wear and implant loading.
用于种植体支持覆盖义齿的附着系统众多，每种系统在固位、成本、磨损、维护和清洁方面都有特定的局限性。对使用杆卡、套筒冠和Locator型附着体修复的种植体支持覆盖义齿患者进行了回顾性分析，并对患者进行了访谈。一项体外应变片研究比较了套筒冠、Locator型附着体和一种采用形状记忆合金（镍钛合金）的新型柔性附着系统在覆盖义齿插入、加载和移除过程中种植体周围应变的发展情况。与套筒冠（P = 0.00007）和Locator型附着体（P = 0.00000）相比，杆卡上观察到的附着相关并发症数量显著更少。杆卡固位修复的患者总体满意度更高，而Locator型附着体导致患者对义齿固位的满意度较低。在体外，套筒冠在义齿插入和加载过程中引起的应变最大，而在移除过程中，白色固位嵌体的Locator型附着体出现这种情况。与套筒冠相比，镍钛合金附着体在插入过程中引起的应变显著更低（P = 0.027）。在加载过程中，镍钛合金附着体引起的应变比蓝色固位嵌体的Locator型附着体显著更低（P = 0.039）。在移除过程中，与白色固位嵌体的Locator型附着体相比，镍钛合金附着体引起的应变显著更小（P = 0.027）。阴阳型附着部件之间的位置差异会影响两者之间的固位和反作用力，使用新型镍钛合金附着系统可将其降至最低。这在部件磨损和种植体负荷方面可能是有益的。
