Sokolowski Alwin, Huber Sandra, Arefnia Behrouz, Pichler Anke, Lorenzoni Martin, Sokolowski Armin
Division of Restorative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, Graz, 8010, Austria.
BMC Oral Health. 2025 Jan 19;25(1):100. doi: 10.1186/s12903-025-05467-8.
Bone preservation is a requirement for long-term stability of dental prostheses, which is all the more important in the posterior mandible, given the particular challenges these areas pose to prosthetic treatment. The objective was to investigate the implications of different prostheses on the atrophy of posterior alveolar bone after tooth loss.
A total of 457 treatment cases were retrieved from the medical documentation and information network. Baseline panoramic radiographs taken at prosthetic delivery and follow-up radiographs (≥ 3 years post-treatment) were available for analysis, with a mean follow-up duration of 6.42 ± 2.37 years. Posterior mandibular bone height in these radiographs was compared using one-way ANOVA followed by the Tukey post hoc test for statistical analysis.
Sites supporting fixed prostheses commonly used in partially edentulous mandibles exhibited less bone atrophy compared to sites with clasp- or telescope-retained removable partial dentures (RPDs) (p < 0.001). Furthermore, sites with clasp-retained RPDs and telescope-retained RPDs demonstrated less bone atrophy when distal support was present (p < 0.001). In edentulous mandibles, bar-retained overdentures supported by four implants exhibited significantly less bone atrophy compared to mucosa-supported complete dentures, bar-retained overdentures supported by two implants, or overdentures retained by Locator abutments on two implants (p < 0.001).
Bone atrophy in the posterior mandible should be expected to vary greatly with prosthetic designs. Long-term stability is possible with fixed partial prostheses, RPDs are less favorable in the absence of a distal support and bar-retained overdentures on four or more implants exhibited the lowest bone atrophy in fully edentulous mandibles.
Not applicable - retrospective analysis.
骨保存是牙修复体长期稳定性的必要条件，鉴于后牙区下颌骨给修复治疗带来的特殊挑战，这在后牙区下颌骨中尤为重要。目的是研究不同修复体对牙齿缺失后后牙牙槽骨萎缩的影响。
从医疗文档和信息网络中检索到总共457例治疗病例。有修复交付时拍摄的基线全景X线片和随访X线片（治疗后≥3年）可供分析，平均随访时间为6.42±2.37年。使用单因素方差分析，随后进行Tukey事后检验对这些X线片中的后牙区下颌骨高度进行比较，以进行统计分析。
与使用卡环或套筒冠固位的可摘局部义齿（RPD）的部位相比，部分牙列缺失下颌骨中常用的固定修复体支持部位的骨萎缩较少（p<0.001）。此外，当有远中支持时，卡环固位RPD和套筒冠固位RPD的部位骨萎缩较少（p<0.001）。在无牙下颌骨中，由4颗种植体支持的杆卡式覆盖义齿与黏膜支持的全口义齿、由2颗种植体支持的杆卡式覆盖义齿或由2颗种植体上的Locator基台固位的覆盖义齿相比，骨萎缩明显较少（p<0.001）。
后牙区下颌骨的骨萎缩预计会因修复设计的不同而有很大差异。固定局部义齿可实现长期稳定性，在没有远中支持的情况下，RPD不太理想，而在完全无牙下颌骨中，由四颗或更多种植体支持的杆卡式覆盖义齿骨萎缩最低。
不适用——回顾性分析。
