Associate Professor, Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Teaching Assistant, Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
J Prosthet Dent. 2024 Oct;132(4):780.e1-780.e9. doi: 10.1016/j.prosdent.2024.03.045. Epub 2024 Apr 26.
The management of patients with narrow-mandibular ridges who seek prosthetic rehabilitation is challenging.
The purpose of this one-year preliminary clinical study was to compare the effects of laser biostimulation and a placebo on peri-implant tissues for a 2-implant-retained mandibular polyetheretherketone (PEEK) overdenture on expanded narrow mandibular ridges.
Eighteen completely edentulous participants were enrolled for mandibular ridge splitting in the canine regions, followed by expansion, the placement of implants, and the application of a bone graft. In the test group, laser therapy was applied labially and lingually at the surgical sites, while a placebo laser was used in the control group. PEEK overdentures retained by LOCATOR attachments were provided after 6 months. Clinical evaluations were performed using probing depth, plaque, bleeding, and gingival indices at insertion and 3, 6, and 12 months after insertion. Vertical bone loss (VBL) was evaluated with periapical radiograph at insertion and 6 and 12 months later. The Mann-Whitney test was used to test the difference between the 2 different groups at each evaluation time (α=.05). The Friedman-test was used, followed by Wilcoxon signed rank test, to test the change over time in the same group, and the Bonferroni adjusted significance level was used for multiple comparisons.
Some clinical and radiographic parameters significantly increased with time in both groups (P<.001). Significant differences between the 2 groups were revealed in bleeding scores at 3 months (P=.006) and 6 months (P=.018). Also, significant differences between the 2 groups were observed in gingival scores at 3 months (P=.002), 6 months (P=.015), and 12 months (P=.019) after overdenture insertion in favor of the laser group. Peri-implant VBL was significantly higher in the non-laser group at 6 months (P=.015), and 12 months (P=.001).
Within the limitations of this clinical study, respecting the small sample size and the short follow-up period, laser bio-stimulation after 1-stage ridge splitting in narrow mandibular ridges enhanced the soft and hard peri implant tissues when used with LOCATOR attachments and PEEK overdentures.
寻求修复体的窄颌骨嵴患者的管理具有挑战性。
本为期一年的初步临床研究的目的是比较激光生物刺激和安慰剂对 2 个植入物保留的下颌聚醚醚酮(PEEK)覆盖义齿在扩大的窄颌骨嵴上的种植体周围组织的影响。
将 18 名完全无牙的参与者纳入犬齿区下颌骨嵴分裂,随后进行扩展、植入物放置和骨移植。在实验组中,激光在手术部位的唇侧和舌侧进行治疗,而对照组则使用安慰剂激光。6 个月后,使用 LOCATOR 附着体提供 PEEK 覆盖义齿。在插入时以及插入后 3、6 和 12 个月进行临床评估,使用探诊深度、菌斑、出血和牙龈指数进行评估。在插入时和插入后 6 个月和 12 个月进行根尖放射线照相评估垂直骨丢失(VBL)。使用曼-惠特尼检验在每个评估时间检验两组之间的差异(α=.05)。使用 Friedman 检验,然后使用 Wilcoxon 符号秩检验检验同一组随时间的变化,使用 Bonferroni 调整的显著性水平进行多重比较。
两组的一些临床和放射影像学参数随着时间的推移均显著增加(P<.001)。在插入后 3 个月(P=.006)和 6 个月(P=.018)时,两组之间的出血评分有显著差异。此外,在插入后 3 个月(P=.002)、6 个月(P=.015)和 12 个月(P=.019)时,两组之间的牙龈评分也有显著差异,有利于激光组。非激光组在 6 个月(P=.015)和 12 个月(P=.001)时的种植体周围 VBL 显著更高。
在本临床研究的限制范围内,考虑到样本量小和随访时间短,在狭窄的下颌骨嵴进行 1 期骨嵴劈开后,使用 LOCATOR 附着体和 PEEK 覆盖义齿时,激光生物刺激增强了种植体周围软硬组织。