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。

Clinical comparative study of implant-supported overdentures retained with bar-clip,ball-cap or locator attachments

The aim was to compare the treatment outcome of implant -supported overdentures retained with bar-clip, ball-cap or locator attachments. Methods： Thirty-eight edentulous patients treated, eleven patients were treated with an overdenture supported by bar-clip attachment, eighteen patients were treated with an overdenture supported by ball-cap attachment and nine patients were treated with an overdenture supported by locator attachment. Standardised clinical and radio- graphic parameters were evaluated 0.5 year after completion of the prosthetic treatment and after each year of functional loading, patient satisfaction was scorded during the evaluated period, too. Results： The latest-evaluated bone loss was 1.3＋1.0mm, 1.2_＋0.8mm, 1.4：t：l.0mm in overdentures retained with bar-clip, ball-cap or locator attachments, respectively. No significant differences in bone loss were ob- served among groups （P〉0.05）. The functional complaints had significantly improved （P〈0.05）. There were no statistically significant differences with regard to any of the studied clinical or satisfaction pa- rameters among the groups. Conclusion： all overdentures can improve masticatory function of edentu- lous patients. For reasons of cost-effectiveness, a two-implant overdenture retained with ball-cap or lo- cator attachments is advised for patients, and overdenture retained with locator attachments is advised for implant with large angulations.