Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Freiburg, Freiburg, Germany; Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland.
J Evid Based Dent Pract. 2023 Sep;23(3):101891. doi: 10.1016/j.jebdp.2023.101891. Epub 2023 May 16.
Aim was to assess whether immediate loading (IL) is more effective than delayed loading (DL) for 2-implant bar-retained mandibular overdentures in terms of oral health-related quality of life (OHRQoL) improvement over a period of 24-month.
In this randomized controlled trial, 32 edentulous patients (mean age: 65.7 ± 10.6 years, 50.0% female) were included. Potential participants had to be unsatisfied with the retention of their current mandibular complete denture and demanded implant treatment for inclusion in the study. OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP) at baseline before treatment and 1, 3, 6, 12, and 24 months after implant loading and insertion of implant-retained bars for overdenture support. A mixed-effects model with patients as random effect and an unstructured covariance matrix was developed to address repeated outcome measurement.
Patients' OHRQoL impairment at baseline was substantial indicated by mean OHIP summary score of 45.1 points. OHIP summary scores decreased substantially from baseline to 1-month follow-up to a mean of 33.5 points (P = .020). OHRQoL further improved during study period indicated by OHIP summary score of 25.7 points at 24-month follow-up. Raw treatment effects (IL vs. DL) ranged from -1.2 OHIP points for 12-month follow-up to 5.8 OHIP points for 24-month follow-up. Assuming constant treatment and time effects, treatment effect was small and not statistically significant (-0.7 OHIP points; P= .918).
A 2-implant bar-retained mandibular overdentures substantially improves OHRQoL over a period of at least 24 months. There seems to be no significant effect of implant loading protocol.
评估对于 2 颗种植体固位杆式下颌覆盖义齿，在 24 个月的时间内，即刻负载（IL）相对于延迟负载（DL）在改善口腔健康相关生活质量（OHRQoL）方面是否更有效。
在这项随机对照试验中，纳入了 32 名无牙颌患者（平均年龄：65.7 ± 10.6 岁，50.0%为女性）。有意愿的参与者对当前下颌全口义齿的固位不满意，并要求进行种植治疗，以纳入研究。在治疗前、植入物负载和植入物固位杆插入以支持覆盖义齿后的 1、3、6、12 和 24 个月，使用 49 项口腔健康影响量表（OHIP）评估 OHRQoL。建立了一个包含患者为随机效应和非结构化协方差矩阵的混合效应模型，以解决重复测量的结果。
患者在基线时的 OHRQoL 受损程度较大，OHIP 综合评分平均值为 45.1 分。OHIP 综合评分从基线到 1 个月的随访显著降低，平均值为 33.5 分（P =.020）。在研究期间，OHIP 综合评分进一步改善，24 个月随访时为 25.7 分。从 12 个月随访的 -1.2 OHIP 点到 24 个月随访的 5.8 OHIP 点，原始治疗效果（IL 与 DL）差异较大。假设治疗和时间效应不变，治疗效果较小且无统计学意义（-0.7 OHIP 点；P=.918）。
2 颗种植体固位杆式下颌覆盖义齿在至少 24 个月的时间内显著改善了 OHRQoL。植入物负载方案似乎没有显著的影响。
