下颌覆盖义齿短微型种植体与标准长度微型种植体效果比较

目的:比较下颌覆盖义齿短微型种植体(mini dental implant,MDI)与标准长度MDI修复牙槽嵴重度萎缩无牙颌患者的效果,为临床应用提供参考.方法:选择进行下颌覆盖义齿短MDI和标准长度MDI修复的无牙颌患者60例,分为短MDI组(30例)和标准MDI组(30例),比较2组基线、术后1周和1年种植体周围组...     

Comparison of two resilient attachment systems for implant-/mucosa-supported overdentures with a PEKK framework: a clinical pilot study

Clinical Oral Investigations - The aim of the study was to determine differences between Locator and CM LOC attachment systems regarding patient satisfaction and wear of the abutments and their...     

按扣型附着体下颌种植覆盖义齿咀嚼效率比较

目的：观察不同支持形式的下颌按扣型附着体种植体覆盖义齿的咀嚼效率。方法：8名患者下颌两侧颏孔之间各植入6个种植体。种植体骨结合后,制作下颌覆盖义齿,分阶段安装太极扣附着体阳性部件。测试2种植体覆盖义齿,4种植体覆盖义齿和6种植体覆盖义齿的咀嚼效率。并进行比较分析。结果：对于采用具有垂直运动的万向绞链按扣型附着体作为连接装置的种植体覆盖义齿,4种植体和6种植体覆盖义齿的咀嚼效率高于2种植体覆盖义齿。6种植体覆盖义齿咀嚼效率与4种植体覆盖义齿咀嚼效率比较无差别。结论：采用上述连接装置,4个以上种植体用于固位、支持和稳定覆盖义齿,可以提高患者的咀嚼效率。     

Masticatory performance with mandibular implant-retained overdentures

It was investigated in a clinical trial whether the masticatory performance of complete-denture wearers depended on the support for their mandibular dentures by implants or mucosa. The trial involved the provision of a new maxillary denture and either a new conventional mandibular denture (mucosa-borne), a mandibular overdenture retained by two IMZ-implants (implant-mucosa-borne), or a mandibular overdenture on a transmandibular implant (TMI; mainly implant-borne). In comparison with mandibular implant-retained overdentures, subjects with conventional dentures needed 1.5 to 3.6 times more chewing strokes for an equivalent reduction in particle size. No differences in masticatory performance were found between subjects with IMZ-implants and those with TMI. This suggests that the increased stability of the mandibular denture with implants determines the wearer's masticatory performance, rather than the support by implants.     

Implant-retained mandibular overdentures with ITI implants

This prospective study has been designed to compare the results of immediate and delayed loading of implant-retained mandibular overdentures after a 2-year follow-up. Twenty patients have been randomly divided into two groups. Group 1 patients (test group) received four ITI implants in the intraforaminal area of the mandible. Octa abutments were immediately screwed on implants; 2 days after surgery, the implants were rigidly connected with a U-shaped Dolder gold bar and loaded with an overdenture. Group 2 patients (control group) received, in the same area, the same type and number of implants, which were left to heal according to the standard protocol. At 3-4 months, Octa abutments were screwed on the implants and the same prosthetic procedure of the test group was applied. The minimum follow-up period lasted 2 years, with recall appointments at 2 weeks, 1, 3, 6 months, 1 year and every following year postoperatively, evaluating: MPI, MBI, PD, Periotest and radiographic peri-implant bone resorption. Success criteria according to Albrektsson et al. were used. Only one implant out of the 40 of group 2 failed, whereas none failed in group 1. No statistical difference of the clinical parameters evaluated was noticed in the two groups. Therefore, immediate loading of implants, if connected with a U-shaped bar, can provide the same results of the 'traditional' technique as far as osseointegration and short-term survival rates of implants are concerned. Moreover, this method significantly shortens the treatment period, thus increasing patient satisfaction.     

Rotational movements of mandibular two-implant overdentures

Objectives: Clinicians have reported that their patients complain that their mandibular two-implant overdentures (IOD) rotate. Therefore, we studied the frequency and severity of rotation of IODs with two-ball attachments, how rotation may influence perceived satisfaction ratings of chewing ability, and the factors that are involved in the rotation of IODs.
Material and methods: Seventy-nine participants were recruited and asked to rate their general satisfaction of their IODs, as well as their ability to chew foods, the existence of any mandibular denture rotation, and to what degree denture rotation bothered them. Data on participant sociodemographic, anatomical, and prosthesis characteristics were also collected. Student's t- test and logistic regression analyses were performed to analyze the differences between participants who did (R group) and did not report (NR group) denture rotation.
Results: Thirty-seven of 79 participants were aware of rotational movement in their IODs. These patients were significantly less satisfied with their chewing ability than those who felt no rotation (69.1 mm R group vs. 82.9 mm), and discomfort caused by the rotation bothered them moderately (39/100 mm). The multivariate logistic regression analysis revealed that the arrangement of the anterior teeth and the length of the denture are significantly associated with awareness of denture rotation. Thirty-eight percent in the R group and 31% in the NR group had non-scheduled visits.
Conclusions: Rotational movement with a mandibular two-IOD has a negative effect on perceived chewing ability and is associated with anterior tooth arrangement and denture length.     

Metal reinforcement for implant-supported mandibular overdentures

Complete and implant-supported mandibular overdenture bases can be a problem because they are especially prone to fracture. Metal reinforcement of the denture base can substantially reduce the incidence of fracture. This article describes 2 methods of reinforcing mandibular overdentures. The advantages of these methods and their indications are discussed.     

球帽覆盖义齿粘固球帽前后咬合特征变化研究

目的：定量研究球帽附着体覆盖全口义齿（complete overdenture,COD）修复后咬合接触分布的变化,初步说明球帽附着体对义齿影响,为临床调（牙合）提供理论依据.方法：采用T-ScanⅡ咬合分析仪进行体内咬合分布特征及咬合时间的测定.全口义齿及球帽附着体覆盖全口义齿修复后患者各16例.球帽覆盖义齿修复患者于粘固球帽前,粘固后3月进行咬合检测,全口义齿修复患者于义齿修复3月后检查咬合分布.记录咬合力中心（center of force,COF）前后位移值（Y）,咬合力前后向分布比率,咬合时间.结果：双侧球帽覆盖义齿粘固球帽后咬合力逐渐增加,高于同期全口义齿,差异有统计学意义（P＜0.05）.球帽覆盖义齿粘固3个月时咬合中心较粘固前前移,与同期全口义齿咬合中心差异有统计学意义（P＜0.05）.全口义齿咬合时间为0.29sec,双侧球帽粘固球帽前为0.27sec,粘固3个月时双侧球帽为0.25sec.差异无统计学意义（P＞0.05）.结论：粘固球帽前覆盖义齿与全口义齿咬合分布状态相似.球帽覆盖义齿粘固球帽3个月内咬合力增大,前牙咬合接触增多,咬合中心前移明显.提示临床对球帽覆盖义齿应在双侧咬合分布平衡同时,注意调整前牙咬合分布.     

种植覆盖义齿临床应用新进展

一、种植覆盖义齿的分类及应用1、种植体支持式,黏膜为主支持式,混合支持式。2、机械式附着体和磁性附着体。3、常用附着体结构:1.杆卡附着体;2.球状附着体;3.磁性附着体三、种植体周围的应力分布GozdeCelik等:球帽与杆卡混合设计的下颌覆盖义齿传导最小的应力到种植体上。刘政:球帽附着体覆盖义齿的剩余牙槽嵴表面应力大于杆式附着体义齿。Lucas Fernando等:与O’RING附着体相比,杆     

Implant-supported mandibular overdentures: a cross-sectional study

Objective: The aim of this cross‐sectional study was to determine the clinical outcome and patient satisfaction in subjects treated with mandibular overdentures supported by two implants. Material and methods: One hundred and fifty‐nine patients, who received restorative therapy in the edentulous mandible consisting of a bar‐retained overdenture supported by two osseointegrated implants in a private clinic in Italy, were recalled for a clinical and radiographic examination. One hundred and forty‐one subjects with 280 implants attended the examination. The average follow‐up time was 3.9 years. The radiographic examination included assessments of the distance between the implant margin and the most coronal position of bone‐to‐implant contact at the mesial and distal aspects of each implant. A questionnaire regarding comfort, satisfaction with the treatment, aesthetics, speaking capacity and efficiency in chewing was obtained from each subject. Biological and technical complications were recorded and the number of visits due to complications between the delivery of the prostheses and the re‐examination was determined. Results: The results from the examination revealed that the number of lost implants was small and the average marginal bone level around the implants was 0.67 mm apical of the implant margin. The most frequently observed complication was hyperplasia of the mucosal tissue under the bar construction. Few patients experienced loosening of retention. The vast majority of patients reported to be satisfied in relation to the restorative therapy from both functional and aesthetic points of view. Conclusion: Patients with edentulous mandibles may be successfully rehabilitated by means of two implants supporting a bar‐retained overdenture. To cite this article:
Bressan E, Tomasi C, Stellini E, Sivolella S, Favero G, Berglundh T. Implant‐supported mandibular overdentures: a cross‐sectional study.
Clin. Oral Impl. Res. 23 , 2012; 814–819.
doi: 10.1111/j.1600‐0501.2011.02225.x     

Pain and instability during biting with mandibular implant-retained overdentures

We tested in a randomized controlled clinical trial the effect of pain and instability of dentures on bite force with different degrees of mucosal support. The trial involved 3 groups who had received: 1) a new conventional denture (CD-group), 2) an implant-mucosa-borne overdenture on 2 IMZ implants (IMZ-group) or 3) a mainly implant-borne overdenture retained by a transmandibular implant (TMI-group). Fifty-three women and 15 men, mean age 59 years, participated in this study. Bite force measurements were made unilaterally with a transducer and bilaterally with a bite fork. After the measurements, subjects were asked whether or not biting had caused pain or tilting of one of the dentures. Significantly more complete-denture wearers reported pain. They reported more frequent pain in the mandible than in the maxilla (P < 0.001), whereas implant-groups seemed to experience more often pain in the maxilla. On the transducer, maxillary dentures of the CD-group tilted less (P < 0.01) and mandibular dentures more (P < 0.05) compared to the implant-groups. With the bite fork, tilting occurred more often in the incisal-cuspid area than in the molar region (P < 0.001). No effect of pain and tilting was observed on maximum bite force. It appears that oral implants used to stabilize mandibular dentures permit subjects to exert higher bite forces and reduce the pain as otherwise felt in the mandible during maximum biting. Due to this stabilization, pain and instability of the maxillary denture can become the limiting factor for a further increase in bite force.     

The masticatory efficiency of mandibular implant-supported overdentures as compared with tooth-supported overdentures and complete dentures

This study assesses the comparative masticatory efficiency (CME) of mandibular implant-supported overdentures (ISOs) to tooth-supported overdentures (TSOs) and complete dentures (CDs). Three groups of patients in equal numbers were evaluated by assessing chewing efficiency, and the results were correlated with tracings of mandibular excursion (ME) and electromyographic (EMG) computerized analysis. CME was measured by utilizing standardized portions of 2 food staples with fixed masticatory sequencing. In a following session, utilizing the same fixed masticatory sequence, tracings of ME and EMG of the masseter and temporal muscles were recorded and analyzed. The results revealed that the ISO provided the greatest degree of efficiency, followed by the TSO and then the CD group. CME is more correlated to ME and less correlated to EMG.