太极扣附着体覆盖全口义齿修复后的组织相容性评价

Histocompatibility evaluation of complete overdenture with sterngold attachment

背景:太极扣附着体固位的覆盖全口义齿较之传统全口义齿稳定性好、固位力强、咀嚼效率高,但由于基牙覆盖在义齿基托下,缺乏口腔的自洁作用,易发生基牙牙周组织炎症而导致覆盖基牙丧失,义齿修复失败。目的:评价太极扣附着体覆盖全口义齿修复后对基牙牙周组织的影响。设计、时间及地点:自身对比观察,于2006-01/2008-12在郑州大学口腔医学院实验室完成。对象:选择2006-01/2007-12就诊于郑州大学口腔医学院口腔修复科的牙列缺损患者20例,女13例,男7例;年龄54～78岁;上颌4例,下颌16例。单颌余留1或2颗尖牙、双尖牙或其残根,松动度不超过Ⅰ度,根长大于或等于8mm,牙槽骨吸收不超过根长的1/2。方法:按常规桩核冠根管预备要求进行基牙的根管预备,取印模,灌模型,完成太极扣附着体单颌覆盖全口义齿,将带有太极扣的金属根桩粘固于基牙根管内,使义齿在口内就位。主要观察指标:每例患者分别在义齿修复前、修复后1,6,12个月,4个时间段测定基牙的牙龈指数、菌斑指数,并拍摄全口牙位曲面体层片,比较修复前和修复后12个月基牙的牙槽嵴高度。结果:修复前和修复后1,6个月的基牙牙龈指数、菌斑指数差异均无显著性意义(P>0.05);修复后12个月基牙的牙龈指数高于修复前(P<0.05)。同一个体修复前和修复后12个月基牙的平均牙槽嵴高度差异无显著性意义(P>0.05)。结论:太极扣附着体覆盖全口义齿修复后对基牙牙周组织的影响较小,组织相容性较好。

BACKGROUND： Compared with traditional complete denture, there are better stability, retention and masticatory efficiency in complete overdenture with sterngold attachment, but, as abutments were covered under the base plate of denture, so they have not self-cleaning action and get periodontitis easily, even lead to the loss of the abutments and failure of the restoration. OBJECTIVE： To evaluate the influence of denture to the abutment periodontium in single complete overdenture patients with sterngold attachment. DESIGN, TIME AND SETTING： A self-controlled observation. The experiment was performed at the Stomatology College of Zhengzhou University from January 2006 to December 2008. PARTICIPANTS： Twenty dentition defect cases were come from the patients of Department of prosthodontics, Stomatology College of Zhengzhou University from January 2006 to December 2007, in which there were 13 females and 7 males, aged from 54 to 78 years old. 4 dentures were in maxilla and 16 in mandible. There were 1 to 2 canine, premolar or their roots in single jaw. The movability of the roots was in I degree, and the length was at least 8 mm; the bone recession was not more than half length of the root. METHODS： Root canal preparation of the abutments were carried out according to the demands of post and core crown, and an impression was made for the model of root canal. Then making single complete overdenture with sterngold attachment in models Putting metal posts with sterngold attachment into the root canal of abutments and bonding them to make denture seating. MAIN OUTCOME MEASURES： Twenty single complete overdenture with sterngold attachment patients were followed, to measure the gingival index and plaque index of the abutment before restored with sterngold attachment overdenture and after restored 1 month, 6 months and 12 months, and taking stomatology tomogram photos before restored and after restored 12 months. RESULTS： There were not significantly differences in the plaque index and plaque index of abutment between before restored and after restored 1 month and 6 months （P 〉 0.05）, but the gingival index of abutment after 12 months was significantly higher than that before restored （P 〈 0.05）. There were not significantly differences in the height of alveolar bone of abutment before restored and after restored 12 months （P 〉 0.05）. CONCLUSION： The influence of the denture to the abutments＇ periodontium is small in complete overdenture patients with sterngold attachment, which shows good histocompatibility.