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。     

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.     

Patient satisfaction with implant-retained mandibular overdentures: a retrospective study

Purpose: The aim of this study was evaluation of the effect of age, gender, and past prosthetic history (duration of edentulism, number of complete dentures before implant treatment, and number of adjustment appointments) on patients' ratings of satisfaction (comfort, hygiene, retention, appearance, speech, mastication, and overall satisfaction). Materials and Methods: In this retrospective study, 55 patients who were treated with mandibular overdentures retained by splinted implants from 1998 to 2004 and met the inclusion criteria of the study were selected. Each patient was asked to fill out a questionnaire to evaluate his/her general satisfaction with the implant prostheses and other aspects of satisfaction such as comfort, aesthetic, function, and hygiene. Data were analyzed using a marginal model and the generalized estimating equations methodology to assess the relationship between the scores and the patients’ demographic and past prosthetic histories. Significance was accepted at 5% and expressed as p values and odds ratio (OR). Results: Gender had significant correlation with comfort (p < .0001). Years of being edentulous prior to implant/prosthetic treatment had direct effects on the general satisfaction and satisfaction of comfort (p < .01). One extra denture used before implant treatment resulted in less comfort (p < .01) and poorer function (p < .001). Elders were more satisfied with aesthetic (OR = 0.96) and comfort (OR = 2.96). Number of adjustment appointments had a positive correlation with comfort (p < .001) and a negative correlation with satisfaction of aesthetic (p < .001). Conclusion: The results of this study demonstrated that satisfaction was correlated with age, gender, and past prosthetic history in the patients rehabilitated with the implant‐supported overdentures.     

LOCATOR附着式种植覆盖全口义齿的临床应用

目的：了解LOCATOR附着式种植覆盖全口义齿的临床应用效果。方法：共完成2枚种植体固位式LOCA-TOR下颌覆盖全口义齿10例,对其机械并发症及修理情况进行随访登记,并定期进行X线片检查。结果：在1-2年的追踪期内,所有种植体无松动,无明显骨吸收,义齿咀嚼及固位满意。1例出现种植体周围牙龈轻度红肿,对症处理后痊愈。结论：LOCATOR附着式种植覆盖义齿稳定性好和固位力强,可以达到临床效果满意。     

Effect of simulated masticatory loading on the retention of stud attachments for implant overdentures

Summary This study assessed the effect of simulated mastication on the retention of two stud attachment systems for 2‐implants overdentures. Sixteen specimens, each simulating an edentulous ridge with implants and an overdenture were divided into two groups, according to the attachment system: Group I (Nobel Biocare ball‐socket attachments) and Group II (Locator attachments). Retention forces were measured before and after 400 000 simulated masticatory loads in a customised device. Data were compared by two‐way anova followed by Bonferroni test (α = 0·05). Group I presented significantly lower retention forces (Newtons) than Group II at baseline (10·6 ± 3·6 and 66·4 ± 16·0, respectively). However, differences were not significant after 400 000 loads (7·9 ± 4·3 and 21·6 ± 17·0). The number of cycles did not influence the measurements in Group I, whereas a non‐linear descending curve was found for Group II. It was concluded that simulated mastication resulted in minor changes for the ball attachment tested. Nevertheless, it reduced the retention of Locator attachments to 40% of the baseline values, what suggests that mastication is a major factor associated with maintenance needs for this system.     

Stud attachments for the mandibular implant-retained overdentures: Prosthetic complications. A literature review

A plethora of attachment systems for mandibular two-implant overdentures is currently available often without evidence-based support. Technical aspects are now parameters considered when choosing the appropriate attachment. Despite the increasing use of the Locator attachments, studies regarding their properties remain scarce. Peer reviewed articles published in English up to 2011, were identified through a MEDLINE search (Pubmed and Elsevier) and a hand search of relevant textbooks and annual publications. Emphasis was made on the technical complications as well as the loss of retention related to the attachments in implant-retained overdentures, primarily the Locator attachment. The evaluation of the long-term outcome of implant overdentures and complications associated with different attachment systems may provide useful guidelines for the clinician in selecting the type of attachment system and overdenture design.     

Biomechenical influence of the different attachments on implant-retained overdentures

目的：评价使用杆式、球形和磁性附着体对种植体支持式下颌覆盖义齿及其种植体的生物力学影响。方法：将两颗种植体代用品植入丙烯酸酯无牙颌模型的双侧尖牙区,在覆盖义齿的基托上粘附４ 块微型应变片,测量分析无附着体,杆式附着体和球形附着体覆盖义齿在４种力加载,５ 种力加载方向条件下的综合应变。结果：覆盖义齿变形在中线处最明显,球形附着体覆盖义齿与无附着体覆盖义齿的应变型相似,综合分析受力发生的应变与分别分析的结果基本一致。结论：杆式附着体覆盖义齿对种植体施加较大的水平力;球形附着体的覆盖义齿更符合粘膜和种植体共同支持牙合力的观点;磁性附着体覆盖义齿能吸收较多的水平分力。     

下颌磁性附着体覆盖全口义齿的临床研究

目的 探讨下颌磁性附着体覆盖全口义齿临床效果。方法 对修复科32例牙列缺损患者行下颌磁性附着体覆盖全口义齿,观察其固位力和咀嚼效率。结果 磁体粘固前、粘固后固位力分别为(1.22±0.15)N、(4.01±0.31)N,差异有统计学意义,咀嚼效率分别为46%±16%、64%±20%,差异也有统计学意义。结论 磁性附着体对改善下颌全口义齿的固位稳定及咀嚼效率的提高有显著作用。     

Patient satisfaction with different types of implant-retained overdentures in the edentate mandible

The purpose of this study was to determine patient satisfaction with implant supported mandibular overdentures using magnet, bar-clip and ball-socket attachments, and to assess the relation between maximum bite force and patient satisfaction. In a crossover clinical trial, 18 edentulous patients with lower denture complaints received 2 mandibular implants and new lower and upper dentures. The lower denture initially came without any kind of attachment system, but was fitted with one of the attachment types after 3 months. The attachments were changed 3 months thereafter, in random order. A questionnaire concerning denture complaints was given at baseline (with the old denture), after 3 months of functioning with the new denture without attachments and after 3 months of functioning with each of the attachments (within-subject comparison). In addition, at the end of the experiment patients were asked to express their overall satisfaction with their dentures on a visual analogue scale (VAS). Data regarding maximum bite force were obtained from a previous study with the same population. Mandibular implant supported overdenture treatment reduced various denture complaints. The VAS score reflected patients' preference more accurately than scale-scores. Patients strongly preferred bar-clip (10 subjects) and ball-socket attachments (7 subjects) over magnet attachments (1 subject). Patients' preference could not be predicted on the basis of baseline observations. Maximum bite force was not correlated to scale- or VAS scores.     

种植磁性覆盖义齿的三维有限元模型的建立

目的 建立磁性附着体固位的种植覆盖义齿的三维有限元模型,为分析磁性附着体对种植覆盖义齿的应力分布的影响奠定基础。方法 采取DICOM 建模法建模,基于CT 医学图像,利用Mimics 医学影像三维重建软件、Geomagic studio 逆行工程软件和SolidWorks 三维设计仿真软件来建立三维有限元实体模型。结果 建立了下颌双种植体支持的种植磁性覆盖义齿的三维有限元模型。结论 该模型可用于分析磁性附着体对种植覆盖义齿应力分布的影响。     

Magfit磁性附着体在下颌覆盖义齿的应用

目的评价磁性附着体在下颌覆盖义齿的临床应用效果。方法为22例患者制作Magfit磁性附着体下颌覆盖义齿,在磁体黏接前后以及戴牙半年时,比较咀嚼效率;用VAS(visualanaloguescale)标尺法由患者自己对义齿的满意程度在上述3个时间点打分,比较VAS评分。在修复开始前及戴牙半年时,比较基牙的牙周情况。结果磁体黏接前、黏接后及戴牙半年时,咀嚼效率、VAS评分差异有显著性(P<0.01)。戴用义齿半年后,所有基牙未发现新发生的根面龋坏及根折,牙周状况均有不同程度的改善,戴牙半年时与磁体黏接时的基牙松动度差异有显著性(P<0.05)。结论磁性附着体用于下颌覆盖义齿,可以改善义齿的咀嚼功能及基牙的牙周状况。     

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.     

Magfit磁性固位体改善下颌全口覆盖义齿固位效果的研究

目的 探讨Magfit磁性固位体在下颌全口覆盖义齿修复中的临床应用.方法 采用Magfit EX600磁性附着体对21例患者行下颌全口覆盖义齿修复,并对义齿的咀嚼效率、固位稳定、基牙健康状况进行12个月的随访观察,采用吸光度法和称重法测量咀嚼效率.结果 黏固磁性附着体后,义齿的固位力和咀嚼效率明显提高.患者对磁性固位覆盖义齿的固位效果满意,自觉义齿稳定性较好.结论 Magfit磁性附着体能有效改善下颌全口覆盖义齿的固位和稳定,提高咀嚼效率,具有良好的临床应用效果.     

磁性附着体在下颌全口覆盖义齿应用中的定量分析

目的:探讨磁性附着体在下颌全口覆盖义齿中的应用价值.方法:用磁性附着体为17例患者制作下颌全口覆盖义齿,粘固磁体前、后,进行最大咬合力、固位力和咀嚼效率测试,并比较2基牙和3基牙磁性附着体全口覆盖义齿的功能效果.采用SPSS13.5软件包对数据进行单因素方差分析.结果:牯固磁体后,全口覆盖义齿的最大咬合力、固位力和咀嚼效率显著提高(P<0.01);3 基牙磁性附着体全口覆盖义齿与2基牙者相比,最大咬合力和咀嚼效率差异无显著性(P>0.05),但固位力显著提高(P<0.01).结论:应用磁性附着体下颌全口覆盖义齿能有效改善覆盖义齿的咬合力、固位力和咀嚼效率;2基牙磁性附着体制作下颌全口覆盖义齿具有良好的临床应用价值.     

Clinical viability of single implant-retained mandibular overdentures: a systematic review and meta-analysis

The aim of this meta-analysis was to verify the clinical viability of single implant-retained mandibular overdentures (SIMO). An electronic search of the PubMed and Cochrane databases was performed (end date July 2017); this was supplemented by a manual search of the literature. Only prospective clinical trials and randomized controlled trials (RCTs) that evaluated SIMO with a minimum follow-up of 12 months were included. The meta-analysis was based on the Mantel–Haenszel method. Dental implant and prosthetic failure were the dichotomous outcome measures; these were evaluated through the risk ratio (RR) and odds ratio (OR), with corresponding 95% confidence intervals (CI). Of 499 articles identified, nine fulfilled the inclusion criteria. A total of 205 implants were placed in patients with a mean age of 64.1 years; the cumulative survival rate was 96.6% over a mean follow-up period of 37.3 months. The procedure used (SIMO vs. two implant-retained mandibular overdenture) did not affect dental implant failure (P = 0.45) or prosthetic failure (P = 0.65): RR 1.06 (95% CI 0.91–1.23) and RR 0.88 (95% CI 0.51–1.51), respectively; OR 2.56 (95% CI 0.27–24.39; P = 0.41) and OR 0.44 (95% CI 0.15–1.26; P = 0.13), respectively. Within the limitations of this systematic review and meta-analysis, SIMO with a complete denture as the opposing arch may be considered an alternative treatment for completely edentulous patients. However, this study also confirmed the need for more RCTs on this topic.