Raffat Eman Mohamed, Shady Mohamed, Elkashty Ayman Abdel Rahim, Syad Moustafa El
Prosthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Prosthodontic Department, Faculty of Dentistry, Benha National University, Obour, Egypt.
BMC Oral Health. 2025 Jun 7;25(1):939. doi: 10.1186/s12903-025-06286-7.
This study assessed the clinical outcomes of fixed and removable implant-assisted prostheses for the rehabilitation of atrophied distal extension mandibular ridges.
Thirty partially edentulous patients with atrophied distal extension mandibular ridges were randomized to three groups (n = 10/group). Group ALF received long implants following alveolar ridge augmentation to support fixed restorations. Group SF received short implants to support fixed restorations. Group OVD received two long implants to support a removable partial denture. The plaque index (MPI), gingival index (MGI), Pocket depth (PD), implant stability (IS), and crestal bone loss (CBL) were assessed: immediately after the prosthesis insertion (T0), six months (T6), and twelve months (T12) later. All groups were assessed for patient satisfaction after 12 months using a visual analogue scale (VAS) survey.
Implant survival rates were 89.7%, 91.7%, and 85% in the ALF, SF, and OVD groups (Chi-square = 0.972, log-rank test, p =.673). The ALF and SF groups had significantly greater plaque and gingival scores (P <.05) than the OVD group At T6 and T12. The ALF group exhibited significantly higher PD and IS values (P ˂ 0.05) compared to the OVD group At T6 and T12. The OVD group had the greatest significant CBL values (P <.05) at T6 and T12, whereas the SF group presented the lowest significant values. The ALF and SF groups showed the highest significant satisfaction levels (P <.05) regarding appearance, esthetics, retention, stability, chewing, bolus quality, and occlusion. On the other hand, the OVD group expressed the highest significant satisfaction (P <.05) with surgery, healing, and cleaning.
Fixed restorations supported by either short implants or long implants inserted in augmented bone are equally successful in the rehabilitation of the atrophic posterior mandible, with improved patient satisfaction than implant-assisted partial dentures. Nevertheless, the SF group had favorable peri-implant soft tissue health and decreased marginal bone loss compared to the ALF group. Conversely, implant-assisted partial overdentures demonstrated favorable peri-implant soft tissue health and increased patient satisfaction regarding surgery and healing compared to fixed restoration.
Current Trial NCT05978115 (28/07/2023) "Retrospectively registered".
本研究评估了固定和可摘种植体辅助修复体用于萎缩性下颌远中延伸嵴修复的临床效果。
30例下颌远中延伸嵴萎缩的部分牙列缺损患者被随机分为三组（每组n = 10）。ALF组在牙槽嵴增高后植入长种植体以支持固定修复体。SF组植入短种植体以支持固定修复体。OVD组植入两颗长种植体以支持可摘局部义齿。评估菌斑指数（MPI）、牙龈指数（MGI）、牙周袋深度（PD）、种植体稳定性（IS）和嵴顶骨吸收（CBL）：在修复体植入后即刻（T0）、6个月（T6）和12个月（T12）。12个月后使用视觉模拟量表（VAS）调查评估所有组患者的满意度。
ALF组、SF组和OVD组的种植体存活率分别为89.7%、91.7%和85%（卡方 = 0.972，对数秩检验，p = 0.673）。在T6和T12时，ALF组和SF组的菌斑和牙龈评分显著高于OVD组（P < 0.05）。在T6和T12时，与OVD组相比，ALF组的PD和IS值显著更高（P < 0.05）。在T6和T12时，OVD组的CBL值显著最大（P < 0.05），而SF组的值最低。ALF组和SF组在外观、美学、固位、稳定性、咀嚼、食团质量和咬合方面的满意度显著最高（P < 0.05）。另一方面，OVD组在手术、愈合和清洁方面的满意度显著最高（P < 0.05）。
在增骨后植入短种植体或长种植体支持的固定修复体在萎缩性下颌后牙区修复中同样成功，患者满意度高于种植体辅助局部义齿。然而，与ALF组相比，SF组种植体周围软组织健康状况良好，边缘骨吸收减少。相反，与固定修复相比，种植体辅助局部覆盖义齿种植体周围软组织健康状况良好，患者对手术和愈合的满意度更高。
当前试验NCT05978115（2023年7月28日）“回顾性注册”
