球帽固位下颌双种植体覆盖义齿修复效果的前瞻性研究

A 3-year follow-up study of mandibular two-implant overdentures retained with ball attachments: clinical outcomes and prosthetic complications

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。

Objective To evaluate the clinical outcomes and prosthetic complications of mandibular two-implant overdentures retained with ball attachments over 3 years. Methods 10 patients with severely reabsorbed mandibular edentulous jaws were treated with delay-loaded mandibular two-implant overdentures retained with ball attachments 3 months after the implants were placed in the mandibular anterior region with good consistency in the horizontal level,angulation,and distance from the midline. The implant survival rate,peri-implant tissue status,prosthetic complications and patients＇ satisfaction were evaluated 1 week,1 year,2 years and 3 years after overdenture rehabilitation. Results Over 3 years＇ rehabilitation of mandibular two-implant overdentures retained with ball attachments,no implants failed,the overall marginal bone loss was lower than 1mm,the mucosal conditions were healthy,and the patients＇ satisfaction was significantly improved and remained high over time. The most common prosthetic complications were replacement or reactivation of an attachment matrix,and the frequency of prosthetic maintenance per patient per year was 0. 67 during the 3-year observation period. Conclusions Mandibular two-implant overdentures retained with ball attachments are a viable treatment modality with good long-term clinical outcomes,on condition that the placement of implants is well designed.