种植支持全牙弓和分段式修复无牙颌患者的对比

Full-arch dental implant restoration versus sectional repair for dentulous mandible

背景:临床对于无牙颌骨患者主要采用种植支持全牙弓和分段式修复,这两种治疗方案各有特点,种植支持全牙弓修复有利于种植体及下颌骨的保护,但对修复体不利;分段式修复对修复体更有利。目的:对比种植支持全牙弓和分段式修复无牙颌患者的临床效果和患者满意度。方法:纳入实施无牙颌种植支持式义齿修复治疗的患者40例,其中28例采用全牙弓式修复,12例采用分段式修复,两组全部采用百康特种植系统及配套的种植体,种植修复完成后对患者进行1年的随访,采用临床检查、X射线评价种植体和骨组织结合成功率。结果与结论:全牙弓式修复组种植成功率为100%,分段式修复组种植成功率为98%,两组间比较差异无显著性意义;全牙弓式修复组修复成功率为97%,分段式修复组修复成功率为98%,两组间比较差异无显著性意义;两组种植后三四个月及修复完成后12个月的骨吸收情况无差异;两组患者对种植义齿的咀嚼功能恢复、固定效果、主观舒适度、发音均比较满意,组间比较差异无显著性意义(P>0.05),但全牙弓式修复组的美观评价、维护方便性及总满意度明显高于分段式修复组(P<0.05)。表明对于无牙颌患者采用种植支持全牙弓和分段式修复均可取得较高的成功率,全牙弓式修复在美观评价、维护方便性等方面患者的满意度优于分段式修复。

BACKGROUND：Ful-arch dental implant and sectional repair are mainly for patients with edentulous mandible, both of which have their own characteristics. Ful-arch dental implant restoration is suitable for the mandibular protection, but has unfavorable effects on the prosthesis; segmented restoration has better effects on the prosthesis. OBJECTIVE：To compare the clinical effectiveness of ful-arch dental implant and sectional repair in edentulous mandible patients as wel as patient satisfaction. METHODS： Forty patients with edentulous mandible underwent ful-arch dental implant restoration （n=28） or sectional repair （n=12）. After restoration, al the patients were folowed for 1 year. Clinical examination and X-ray observations were performed to evaluate the osseointegration rate. RESULTS AND CONCLUSION：The success rate of implants was 100% in the ful-arch group and 98% in the sectional repair group, and there was no difference between the two groups （P 〉 0.05）. The successful restoration rates were 96.5% and 98% in the two groups, respectively, with no significant difference （P 〉 0.05）. Bone resorption showed no difference between the two groups at 3-4 months after implantation or at 12 months after restoration. Patients in the two groups were al satisfied with masticatory function, fixed effect, subjective comfort and pronunciation are satisfactory, and there was no statisticaly significant difference （P 〉 0.05）. However, beautiful evaluation, maintenance convenience and total satisfaction were significantly higher in the ful-arch group than the sectional repair group （P 〈 0.05）. These findings suggest that both ful-arch dental implant restoration and sectional repair can have better effects on edentulous mandible, but the former one is superior to the latter one in the folowing aspects： beautiful evaluation, maintenance convenience and total satisfaction.