Faculty of Dentistry, University of Mansoura, Mansoura, Egypt.
Removable Prosthodontics, Faculty of Dentistry, Delta University, Belqas, Egypt.
Clin Implant Dent Relat Res. 2023 Oct;25(5):795-806. doi: 10.1111/cid.13212. Epub 2023 May 8.
This trial evaluated clinical outcomes of fixed and removable implant-supported prostheses for rehabilitation of atrophied distal extension maxillary ridges.
A total of 54 participants with atrophied distal extension maxillary ridges were randomly assigned into three groups (n = 18/group). Group I (SLF); participants treated with fixed restoration supported by three long implants after sinus augmentation, Group II (SF); participants treated with fixed restoration supported by one long and two short implants, and Group III (OD): participants treated with removable partial denture assisted by one long implant that was placed mesial to maxillary sinus (IARPD). Modified plaque index (MPI), modified gingival index (MGI), pocket depth (PD), implant stability (IS), and crestal bone loss (CBL) were measured after prosthesis insertion (T0), 6 (T6), and 12 months (T12) after insertion. Patient satisfaction was measured at T12 using a visual analog scale (VAS).
The implant survival rates were 96.8%, 92.4%, and 84.6% for SLF, SF, and OD groups respectively. The SLF recorded the highest MPI, MGI, PD, and IS values, followed by the SF, and the OD showed the lowest values. The OD recorded the highest CBL followed by the SF and the SLF showed the lowest CBL. With exception of satisfaction with surgery and cleaning, SLF and SF groups recorded significantly higher patient satisfaction than the OD for all VAS questions.
Fixed restorations supported with either long or short implants were associated with improved implant stability, reduced bone loss, and increased patient satisfaction compared to implant-assisted RPDs. However, implant-assisted RPDs were associated with more favorable peri-implant soft tissue health and increased satisfaction with surgery, healing, and cleaning.
本试验评估了用于修复萎缩性上颌远中延伸牙槽嵴的固定式和可摘式种植体支持修复体的临床效果。
共有 54 名患有萎缩性上颌远中延伸牙槽嵴的患者被随机分为三组（每组 18 例）。I 组（SLF）：经鼻窦提升后，用 3 个长种植体支持的固定修复体治疗；II 组（SF）：用 1 个长种植体和 2 个短种植体支持的固定修复体治疗；III 组（OD）：用放置在上颌窦（IARPD）内侧的 1 个长种植体辅助的可摘局部义齿修复。在修复体插入后（T0）、插入后 6 个月（T6）和 12 个月（T12）时，测量改良菌斑指数（MPI）、改良龈炎指数（MGI）、牙周袋深度（PD）、种植体稳定性（IS）和牙槽骨吸收（CBL）。在 T12 时，使用视觉模拟评分（VAS）测量患者满意度。
SLF、SF 和 OD 组的种植体存活率分别为 96.8%、92.4%和 84.6%。SLF 组的 MPI、MGI、PD 和 IS 值最高，其次是 SF 组，OD 组的最低。OD 组的 CBL 值最高，其次是 SF 组，SLF 组的 CBL 值最低。除对手术和清洁的满意度外，SLF 和 SF 组在所有 VAS 问题上的患者满意度均显著高于 OD 组。
与种植辅助 RPD 相比，用长或短种植体支持的固定修复体可改善种植体稳定性，减少骨吸收，并提高患者满意度。然而，种植辅助 RPD 与更好的种植体周围软组织健康和增加对手术、愈合和清洁的满意度相关。
