杆卡、球帽和locator附着体种植覆盖义齿的临床对比研究

目的：比较杆卡、球帽、locator附着体种植覆盖义齿修复1．3年后的临床效果。方法：对38名无牙颌患者进行覆盖义齿修复,其中杆卡、球帽、locator附着体种植覆盖义齿分别为11、18和9例。在义齿完成后0．5、1年及每年复查1次。对各组种植体周围粘膜状况和边缘骨吸收（MBL）进行评估,同时检验患者满意度。结果：杆卡、球帽、locator附着体最近一次随访的种植体边缘骨吸收为（1．3±1．0）ram、（1.2±0．8）mm、（1．4±1．0）mm,3种方式修复后MBL比较无统计学意义（P〉0．05）。与原有全口义齿比较,患者满意度均有明显提升（P〈0．05）。三种义齿间种植体周围粘膜状况、患者满意度亦无统计学差异。结论：杆卡、球帽、locator附着体种植覆盖义齿均能明显改善无牙颌患者的咀嚼功能。出于经济学考虑,我们建议选用2枚种植体支持的球帽或locator附着体覆盖义齿,临床上角度偏差较大的种植体可以优先考虑locator附着体覆盖义齿修复。     

球帽固位下颌双种植体覆盖义齿修复效果的前瞻性研究

目的 评价球帽固位的下颌双种植体覆盖义齿的临床修复效果及其修复并发症。 方法 对下颌牙槽骨重度萎缩的10例无牙颌患者,在前牙区与中线等距平行植入2枚种植体,3个月后采用球帽附着体固位方式制作下颌种植覆盖义齿。在覆盖义齿戴入后1周、1年、2年、3年进行随访,评价种植体边缘骨吸收情况、种植体周围软组织健康状况、患者满意度及义齿并发症情况。 结果 10例两球帽固位的下颌种植覆盖义齿经过3年观察,种植体存留率100%,边缘骨吸收<1 mm,种植体周围软组织健康,患者满意度显著提高且维持稳定,义齿无重衬或折断现象,义齿并发症主要是球帽附着体O型圈的置换或固位金属簧的固位力再激活,修理频次0.67次/(年·人)。 结论 在种植体植入位置、方向合适的情况下,球帽附着体固位的下颌双植体覆盖义齿,可获得长期稳定的临床修复效果。     

杆卡和球帽附着体下颌种植覆盖义齿放射学对比研究

目的：了解杆卡和球帽附着体下颌种植覆盖义齿修复后种植体周齿槽骨的变化。方法：同顾性分析42例全颌牙缺失病例在下颌区各植入2颗种植体,行种植体支持覆盖义齿修复的病例,其中杆卡下颌种植覆盖总义齿19例,球帽式下颌覆盖总义齿23例。对其定期进行随访及放射学检查获得的数据进行总结。结果：杆卡和球帽附着体下颌种植覆盖义齿修复后2年,种植基牙周齿槽骨吸收情况经统计学处理没有差别。结论：杆卡和球帽附着体下颌种植覆盖义齿修复后,短期对种植体基牙周齿槽骨影响没有明显差别。     

球帽式和Locator式下颌种植覆盖总义齿的临床效果观察

目的：评价球帽式和Locator式下颌种植覆盖总义齿的临床应用效果。方法：共完成2颗种植体支持的球帽下颌覆盖总义齿9例,Locator下颌覆盖总义齿11例,上颌均制作可摘局部义齿。修复完成后于3、6、12、24个月进行随访,对各组种植体周围边缘骨吸收（MBL）进行评估,同时进行义齿满意度调查。结果：Locator组、球帽组在咀嚼功能、固位功能和舒适程度的满意度均高于治疗前,有显著性差异（P〈0.05）;Locator组与球帽组患者满意度、种植体周牙槽骨吸收量差异无统计学意义。结论：使用球帽、Locator附着体种植覆盖义齿在下颌无牙颌的应用中临床效果明显。     

无牙颌患者种植义齿修复

目的:无牙颌患者采用种植义齿修复可有效的增强义齿的固位,提高义齿的修复效果。方法:从1999年至2007年,对22例无牙颌患者,年龄45-82岁,行种植义齿修复,其中,有2例采用种植固定义齿修复,7例采用杆-卡式种植覆盖义齿修复,11例采用球-帽式种植覆盖义齿修复,1例采用双套筒冠种植覆盖义齿修复,1例采用磁性固位种植覆盖义齿修复。患者种植体植入2-9颗,共植入种植体97枚,种植体采用Frialit-2,Fri-alit-xive系统,观察时间108个月,采用临床检查、X线观察和患者主观评价等来评价种植体与骨组织结合状态,评价其义齿的修复效果。结果:观察期内发现1枚种植体脱(球-帽式固位种植体),1枚种植体未作修复,仍埋入在粘膜下的颌骨内。种植义齿修复后固位稳定作用良好,患者咀嚼有力,对义齿修复效果满意。结论:无牙颌患者种植义齿修复效果良好,患者满意度高。     

两种附着体种植覆盖义齿的临床效果比较

目的 评价球帽附着体和Locator 附着体应用于无牙颌患者种植覆盖义齿的临床效果.方法 选择无牙颌行种植覆盖义齿修复患者67例,共植入150颗种植体,附着体类型为球帽或Locator.对患者定期复查,检查种植体的牙周袋探诊深度(PPD),菌斑指数(PLI),牙龈指数(GI)和龈沟出血指数(BI),测量边缘骨吸收值(MBL).患者分为球帽组、球帽改Locator组和Locator组,对PPD值、MBL值和PLI、GI、BI分别进行3组间比较.使用Digimizer图像分析软件进行影像学测量,采用SPSS17.0软件进行统计分析.结果 150颗种植体修复前成功率为95.88%,累计存留率为92.97%.PPD值平均为(2.16 ± 1.02)mm,球帽组与改做组间无显著差异,Locator组的PPD值明显低于另2组.PLI、GI和BI的组间差异均无统计学意义.MBL值平均为(0.92 ± 0.61)mm,改做组的MBL值明显高于另2组,而Locator组的MBL值最低.结论 Locator式种植覆盖义齿比球帽式种植覆盖义齿的临床效果具有一定优势.     

下颌无牙颌种植修复设计体会

目的:探讨下颌无牙颌种植体植入位置、数目与修复设计的关系。方法:采用Frialit-2种植体36枚和Endo-pore种植体6枚对8例下颌无牙颌患者进行了种植修复,其中2例进行了杆卡覆盖义齿修复,2例球帽覆盖义齿修复,4例种植固定义齿修复。结果:二期手术时,42枚种植体均形成了良好的骨性结合。经6~24个月的临床修复观察,种植体负重6个月时骨吸收平均0.5mm±0.02mm,戴义齿12个月后骨吸收平均0.1mm±0.03mm。修复的种植义齿能较好地行使咀嚼功能,收到了满意的临床效果。结论:对于下颌无牙颌的种植患者,合理的治疗计划,对于保障种植义齿的修复效果及维持种植体的长期成功率是重要的。     

磁性固位种植覆盖义齿在无牙颌修复中的应用

目的:为解决牙槽骨严重吸收无牙颌患者的修复难题,探讨磁性附着体种植覆盖义齿在临床上的应用效果。方法:本文对12例牙槽骨严重吸收的无牙颌患者均采用2枚CDIC种植体,4-6个月后进行磁性附着体覆盖义齿修复,每半年复诊,观察义齿使用情况,并结合临床检查和X线检查评价效果。结果:12例患者24枚种植体均达到骨结合,12件覆盖义齿固位良好,患者满意度100%,义齿稳定性较好,患者满意度90%。结论:磁性固位种植体覆盖义齿用于牙槽骨严重吸收的无牙颌患者修复治疗,临床效果好,值得推广。     

种植体直径对下颌覆盖义齿植体边缘骨吸收影响的3年回顾性研究

目的 研究窄颈和常规颈种植体支持的下颌球帽覆盖义齿边缘骨吸收 (MBL)、机械并发症及患者满意度。方法覆盖义齿的设计方案为下颌无牙颌植入2枚种植体,上部附着体为非夹板式球帽结构。共分为2组：① 窄颈种植体(?=3.3 mm)为26例,52 枚种植体;② 常规颈种植体 (?=4.1 mm)为28例,54枚种植体。分别在佩戴覆盖义齿后的6个月、1年及3年,通过临床检查及影像学观察种植体周围软组织情况 (牙周袋深度、牙龈出血指数、菌斑指数及牙结石指数)、边缘性骨吸收（MBL）、修复并发症,并采用问卷调查患者满意度。结果 在3年的随访期内,108枚种植体均无松动脱落。窄颈和常规颈种植体组的平均MBL分别为（2.1±0.4）mm,（1.4±0.3）mm,两者差异具有统计学意义。窄颈和常规颈种植体组的维修频率分别为0.26、0.27次/（年?人）,患者满意度后者略高于前者,但上述两组数据无显著性差异。结论 3年的回顾性研究表明,在使用种植体支持下颌球帽覆盖义齿修复中,种植体的直径会对其边缘骨吸收产生一定影响。使用常规颈植体的边缘骨吸收少于窄颈植体,但两者机械并发症和患者满意度没有差异性。     

不同类型种植覆盖义齿临床疗效的回顾性研究

目的:回顾性分析无牙颌不同类型种植覆盖义齿的临床疗效.方法:随访46名种植覆盖义齿修复的无牙颌患者,进行影像学和临床检查,并记录机械并发症的发生情况.通过种植体存留率、边缘骨吸收量、种植体周围软组织情况、机械并发症发生情况和患者满意度来评估种植体覆盖义齿的临床疗效.结果:在随访时间内(64±36)月,种植体存留率是93...     

Maxillary overdentures retained by splinted and unsplinted implants: a retrospective study

The purpose of this retrospective study was to evaluate the clinical performance of and patients' satisfaction with maxillary overdentures retained by splinted and unsplinted implants. Patients who had been treated with maxillary implant-retained overdentures because of functional problems with conventional complete dentures were identified and invited to participate in the study. A total of 16 patients fulfilled the enrollment criteria and agreed to participate. Eleven patients were treated with bar-retained overdentures with 3 to 6 clips (mean follow-up 32 months), and 5 patients wore overdentures retained by 2 to 6 ball attachments (mean follow-up 54 months). All subjects were satisfied with their prostheses, and most subjects experienced improvement in their oral function after treatment with implant-retained overdentures. At the time of clinical examination, 92% (n = 77) of the 84 implants placed were functioning satisfactorily. The cumulative survival rate for the implants after 72 months was 90%. Loss of bone support correlated with peri-implant probing depth (r = 0.29; P < .02). No differences in mean bone loss between the subjects with ball-retained or bar-retained overdentures were found. The presence of plaque or peri-implant bleeding was not associated with the type of attachment.     

Comparison of 2 retentive systems for implant-supported overdentures: soft tissue management and evaluation of patient satisfaction

BACKGROUND: The aim of the present study was to compare the peri-implant soft tissue health status of implants supporting overdentures with bar attachments or ball attachments in the mandible, as well as patient satisfaction with these attachment types. METHODS: The study included a Dolder bar group with 18 cases (43 implants) and a ball attachment group with 18 cases (51 implants). The mean function period in the Dolder bar group was 49 months (range: 12 to 72 months) and in the ball attachment group, the mean was 23 months (range: 12 to 40 months). Implants were clinically evaluated by using a modified plaque index (mPI), modified sulcus bleeding index (mSBI), and probing depths. Patient satisfaction with the treatment was recorded using a questionnaire. RESULTS: mPI, probing depth, and mSBI did not statistically differ between groups (Mann-Whitney U test, P > 0.05). Patient satisfaction was similar with both retentive systems. CONCLUSION: Within the limits of this study, we concluded that there was no significant difference between the 2 attachment types used for implant-supported overdentures with respect to the soft tissue health status or patient satisfaction.     

The reliability of implant-retained hinging overdentures for the fully edentulous mandible An up to 9-year longitudinal study

The treatment of fully edentulous mandibles by means of implant-supported hinging overdentures has become a routine therapy, although long-term data on the success rate of implants and prostheses are lacking. This longitudinal study examined 207 consecutively treated patients who received, during the past 10 years, 449 Brånemark implants to retain a mandibular hinging overdenture, mainly on a Dolder bar. Clinical parameters and standardized radiographs taken at every recall visit with an interval of 6–12 months were used to judge the implant rigidity in the jawbone, the marginal bone level, and attachment level changes. The cumulative implant failure rate at 9 years was 3%. After loading, implant loss was concentrated during the first 12 months, with only one failure observed at 22 months. A radiographically determined bone loss of 0.7 mm was observed during the first year. From the second year, a mean annual bone loss of 0.05 mm occurred. The attachment loss, calculated as the sum of probing pocket depth plus the recession, was 0.07 mm/year and paralleled the changes in marginal bone level over time. The rigidity of the implant–bone interface revealed an increase over time, as shown by a decrease in Periotest values. The bar–overdenture complications were related to relining (23%), untightening of the retention clip (10%), and renewal of the prosthesis (7%). When magnets or ball attachments were used, more aftercare was needed. Fracture of the antagonistic full denture occurred in 7% of patients. The present data indicate that the mandibular overdenture therapy on two (Brånemark) implants is a very reliable and cost-effective treatment, even in a long-term perspective for the fixed full mandibular prosthesis and especially in elderly patients.     

Implant-supported mandibular overdentures retained with ball or bar attachments: a randomized prospective 5-year study

PURPOSE: The aim of the present study was to evaluate the periimplant conditions and the maintenance requirements for implant-supported overdentures in the mandible retained with ball or bar attachments during a 5-year period. MATERIALS AND METHODS: Twenty-six completely edentulous patients had two Astra Tech dental implants placed in the anterior part of the mandible. The denture attachment system for the patients was chosen randomly by drawing lots. Eleven patients drew the bar attachment system and fifteen patients drew the ball attachment system. Plaque Index, Gingival Index, and probing pocket depth were assessed around each implant. Periotest values were recorded, and periodically identical intraoral radiographs were obtained with a specially designed film-holding device. RESULTS: No implants were lost from baseline to the 5-year registration. The periimplant conditions were very healthy after 5 years. No significant differences of the periimplant variables were recorded between the bar and the ball groups. During the first year of function, significantly more complications/repairs were registered in the bar group than in the ball group. In the following years, no significant differences were registered. The mean frequency of complications/repairs per patient per year was 1.0 in the bar group and 0.6 in the ball group during the 5-year observation period. CONCLUSION: Two implants with ball or bar attachment supported an overdenture in the mandible for 5 years with a 100% survival rate. No differences in marginal bone loss or health of the periimplant mucosa were observed between bar and ball attachment, but the frequency of technical complications/repairs per patient was higher around bar than ball attachments.     

Locator附着体和球帽附着体在种植覆盖义齿中的临床修复效果比较

目的探讨球帽基台和locator基台在种植体覆盖义齿(IODs)修复中临床效果的比较。方法选择单颌牙根嵴严重萎缩全口无牙颌患者27例,共计54枚种植体,其中球基台附着体26枚,locator基台附着体28枚。上部修复完成后6个月复诊并每年随访,从种植体、牙周黏膜、附着体等方面进行复查,统计其总的并发症发生率并对患者的满意度进行评价。结果两种基台支持式覆盖义齿患者的满意度明显高于普通全口义齿(P<0.05)。2年后两种附着体种植覆盖义齿边缘骨吸收率(BML)没有差别(P>0.05)。locator基台支持的覆盖义齿并发症的发生率仅为14.28%,球帽种植覆盖义齿总的并发症发生率为38.46%。结论 locator基台和球帽基台支持式全口义齿均优于常规全口义齿,locator基台产生的并发症更少。     

Mandibular overdentures stabilized by Astra Tech implants with either ball attachments or magnets: 5-year results

PURPOSE: The purpose of this work was to report on the use of implant-stabilized overdentures in the mandible using the Astra Tech implant system with either ball attachments or magnets as the retentive mechanism. MATERIALS AND METHODS: Mandibular overdentures that used ball attachments on 2 implants were provided for 13 edentulous patients; 12 edentulous patients were provided with mandibular overdentures with magnet retention, using 2 implants in 10 patients and 3 implants in 2 patients. Once they were comfortable, the participants were placed on annual recall. Any other visits were initiated by the patients. Detailed records were kept for all visits. At the annual recall the following parameters were monitored: plaque levels, mucosal health, marginal bone levels, and the patients' assessment of the treatment. The patients were followed for 5 years. RESULTS: There was no statistical difference between the 2 groups for mucosal health and postinsertion maintenance. The magnet group had more abutment surfaces covered with plaque. Statistical analysis of the patients' subjective assessment of their treatment showed that the magnet group was less comfortable and chewing was less effective. CONCLUSION: The results indicate that both ball attachments and magnets used on isolated Astra Tech implants in the mandible are viable treatment options. Both attachment mechanisms provided patient satisfaction, although the ball attachments were better in this respect than the magnets.     

Implant-supported mandibular overdentures retained with ball or telescopic crown attachments: a 3-year prospective study

PURPOSE: The aim of the present study was to evaluate implant survival, peri-implant conditions, and prosthodontic maintenance requirements for implant-supported mandibular overdentures in atrophic mandibles retained with ball or resilient telescopic crown attachments during a 3-year period. MATERIALS AND METHODS: Twenty-five patients with edentulous mandibles each received 2 Camlog root-form dental implants in the mandibular interforaminal (canine) region. The denture attachment system was chosen randomly; 13 patients received ball attachments and 12 patients received resilient telescopic crowns. Implant survival, implant mobility (Periotest values), and peri-implant conditions such as bone resorption, pocket depth, Plaque Index, Gingiva Index, Bleeding Index, and Calculus Index values were assessed for each implant. In addition, detailed prosthodontic maintenance was evaluated during the follow-up period and the 2 retention modalities were compared. RESULTS: There were no differences in implant survival, implant mobility (Periotest values), and peri-implant conditions between the 2 retention modalities. During the 3-year period significantly more complications/interventions for maintenance purposes were registered in the ball group (62 interventions) than in the telescopic crown group (26 interventions; P < .01). CONCLUSION: The results indicate that both ball attachments and resilient telescopic crowns used on isolated implants in the edentulous mandible are viable treatment options. Implant success and peri-implant conditions did not differ between ball attachments and telescopic crowns used as retention modalities for implant overdentures, but the frequency of technical complications was significantly higher with ball attachments than with resilient telescopic crowns.     

A clinical comparison of prosthetic complications of implant-supported overdentures with different attachment systems

OBJECTIVES: The objective of this clinical study was to evaluate the prosthetic complications of patients with 2 to 4 implants splinted with a round bar or with 2 to 4 unsplinted implants with ball attachments during the follow-up period. METHODS: A total of 26 patients were included in this study. Patients were randomly provided with a round bar or with ball attachments that were used to retain overdentures. During follow-up visits, the following prosthetic complications were recorded: round bar fracture, fractured overdenture, hygiene complications, abutment screw loose, worn O-ring or replacement of O-ring attachment, and fractured retention clip. The functioning period of overdentures in the round bar group ranged from 12 to 72 months (mean 49), and from 12 to 40 months (mean 23) in the ball attachment group. RESULTS: A total of 20 prosthetic complications were recorded in both groups. No differences in prosthetic complications were observed for 2 attachment systems. CONCLUSION: Implant-supported overdentures with bar or ball attachments may be considered to be reliable methods in the treatment of the edentulous individuals.     

A 5‐year randomized clinical trial on the influence of splinted and unsplinted oral implants in the mandibular overdenture therapy. Part I: peri‐implant outcome.

Thirty-six completely edentulous patients were enrolled for a 5-year prospective study testing the treatment outcome between splinted and unsplinted implants retaining a mandibular hinging overdenture. The patients were randomized into 3 groups of equal size depending on the attachment system used such as: magnets, ball attachments or bars (reference group). Only 1 implant out of the 72 had failed at the abutment stage. Not a single implant failed during the 5-year loading period. The accumulation of plaque was significantly higher for the Magnet than for the Ball group. Bleeding on probing, as well as marginal bone level, attachment level and Periotest values did not statistically differ among the groups, neither at year 1 nor at year 5. However, the Periotest values were significantly lower at year 5 compared to year 1 for all groups, which indicates a higher rigidity at the bone-implant interface. No correlation was found between bleeding on probing and marginal bone loss. We conclude that the connection state of 2 implants retaining a hinging overdenture did not influence the peri-implant outcome.