不同附着体固位种植覆盖义全口义齿的临床应用疗效对比

Clinical evaluation of planting overdentures with different types of attachments

目的探讨杆卡式附着体固位和按扣式附着体固位的种植覆盖全口义齿的临床应用疗效,为无牙颌患者的全口种植覆盖修复方式提供理论依据。方法共纳入86例全口无牙颌需行种植覆盖全口义齿修复的患者作为研究对象,采用随机数字法平均分为杆卡组与按扣组,分别给予杆卡式附着体固位和按扣式附着体固位,随访2年对固位性能、咀嚼性能、舒适度等级牙周情况进行比较。结果杆卡组咀嚼效能、义齿稳定性满意例数明显高于按扣组,且咀嚼效率亦明显高于按扣组,差异有统计学意义(P<0.05)。两组边缘骨吸收相比差异无统计学意义(P>0.05)。随着时间推移杆卡组与按扣组菌斑指数均有明显改善,差异有统计学意义(P<0.05);术后6个月及术后12个月杆卡组与按扣组菌斑指数比较差异无统计学意义(P>0.05);但术后24个月杆卡组菌斑指数明显低于按扣组,差异有统计学意义(P<0.05)。结论杆卡式及按扣式附着体均可以有效改善无牙颌种植修复患者术后的牙周情况,但杆卡式附着体可以更早改善牙周情况,且长期降低菌斑指数更明显,同时患者对杆卡式附着体在义齿稳定性、咀嚼效能方面的满意度更高。

【Objective】 To summarize and evaluate the clinical effect of planting overdentures with different types of attachments so as to provide theoretical basis for the application of overdentures.【Methods】In this study 86 patients with complete toothless jaw were included.The patients were divided into lever cassette group and snap fastener group,and they were given lever cassette and snap fastener retainer respectively.The retention performance,masticatory performance and comfort level were compared after 2years.【Results】 There were more cases satisfied with masticatory efficiency and stability of the denture in the lever cassette group than in the snap fastener group,the difference was statistically significant（P〈0.05）.The chewing efficiency in the lever cassette group was statistically higher than that in the snap fastener group（P〈0.05）.There was no statistically significant difference in the marginal bone resorption between both groups（P〈0.05）.The plaque index was significantly improved with prolonged treatment in both groups（P〈0.05）.The plaque index after 24 months in the lever cassette group was lower than that in the snap fastener group,the difference was statistically significant（P〈0.05）.There were no differences in plaque index after 6 months and12 months between both groups（P〉0.05）.【Conclusions】 Both lever cassette attachment and snap fastener attachment can effectively improve the periodontal condition,but lever cassette attachment can improve periodontal condition earlier and reduce plaque index more apparently for a long time.Meanwhile,patients with lever cassette attachment are more satisfied with masticatory efficiency and stability of the denture.