Aboelez Marwa Ahmed, Ibrahim Christine Raouf Micheal, Helmy Mohamad Hossam El-Din, Elsyad Moustafa Abdou
Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Faculty of Dentistry, Assiut University, Assiut, Egypt.
Clin Implant Dent Relat Res. 2024 Feb;26(1):103-112. doi: 10.1111/cid.13291. Epub 2023 Nov 5.
This study aimed to evaluate the clinical outcomes and patient satisfaction of 4-implant-assisted maxillary overdentures using two different designs.
Thirty edentulous participants received four implants in the maxillary ridge. The patients were randomly divided into two equal groups: (1) the control (CG, Vertical) group (n = 15); participants received four vertical implants with straight locator attachments to retain maxillary overdentures, and (2) the study (SG, Angled) group (n = 15); participants received four angled implants with angled locator attachments to retain maxillary overdentures. Peri-implant tissue health [Plaque (PL) and gingival (GI) indices, pocket depth (PD), implant stability (ISQ) 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 (VAS) after 12 months.
The survival rates were 96.7% and 95% for the control and study groups respectively. PL, GI, and PD increased significantly in both groups with the passage of time. No significant difference in PL, GI, PD, and ISQ was noted between groups at all observation times. CG showed higher CBL than SG at T12. For the VAS results, there was no significant difference between groups. SG recorded significantly higher satisfaction regarding comfort with maxillary and mandibular dentures, retention of mandibular dentures, oral hygiene, the ability to chew hard food, and occlusion than CG.
Within the limitations of this study, angled implants with angled locator attachments may be recommended to retain maxillary overdentures opposing intact dentition or fixed restoration as it was associated with improvements of several parameters of peri-implant tissue health and patient satisfaction compared to vertical implants with straight locator attachments.
本研究旨在评估使用两种不同设计的4种植体支持上颌覆盖义齿的临床效果和患者满意度。
30名无牙颌参与者在上颌牙槽嵴植入4枚种植体。患者被随机分为两组，每组15人：（1）对照组（CG，垂直组）；参与者接受4枚垂直种植体及直型定位附着体以固位上颌覆盖义齿；（2）研究组（SG，角度组）；参与者接受4枚角度种植体及角度定位附着体以固位上颌覆盖义齿。在义齿戴入后（T0）、戴入后6个月（T6）和12个月（T12）评估种植体周围组织健康状况[菌斑（PL）和牙龈（GI）指数、袋深（PD）、种植体稳定性（ISQ）和嵴顶骨吸收（CBL）]。12个月后使用视觉模拟量表（VAS）评估患者满意度。
对照组和研究组的生存率分别为96.7%和95%。随着时间推移，两组的PL、GI和PD均显著增加。在所有观察时间点，两组之间的PL、GI、PD和ISQ均无显著差异。在T12时，CG的CBL高于SG。对于VAS结果，两组之间无显著差异。与CG相比，SG在上颌和下颌义齿舒适度、下颌义齿固位、口腔卫生、咀嚼硬食物能力和咬合方面的满意度显著更高。
在本研究的局限性内，对于上颌覆盖义齿对抗完整牙列或固定修复的情况，推荐使用带角度定位附着体的角度种植体，因为与带直型定位附着体的垂直种植体相比，它与种植体周围组织健康的多个参数改善及患者满意度提高相关。
