无牙颌种植覆盖义齿的循证基础、设计方案及临床关键问题

Treatment planning and key points in clinical procedure of implant overdenture for edentulous patients

多项大样本量随机对照临床研究证实,牙列缺失采用种植覆盖义齿修复,比常规全口义齿能提高义齿的固位与稳定,并可提供更高的咀嚼效率;无牙颌种植覆盖义齿的设计应综合考虑患者的解剖条件、牙槽骨吸收程度、颌间距离等因素,选择适合的种植体数目、分布及上部附着体。在覆盖义齿的临床操作过程中,应针对不同类型的覆盖义齿,在适当的时机戴入上部附着体,并合理选择适用的印模技术、颌位关系记录、试牙排牙及戴牙方法,才能保证修复效果的长期稳定。本文对种植覆盖义齿的临床意义、治疗设计、临床操作流程中的关键步骤与义齿戴入后的复查与维护等方面进行详细阐述。

Many randomized controlled clinical trials have reported that implant overdentures provided edentulous people with better retention,stability,and masticatory performance than conventional complete dentures did.The design of implant overdentures for edentulous jaws should be based on comprehensive consideration of factors such as anatomic structure,alveolar bone resorption,inter-arch distance,choice of implant number/distribution and suprastructure.During the clinical procedure,timing of attachment connection,choice of impression technique,methods of maxilla-mandibular relationship registration,wax-up try-in,and prostheses delivery should be determined according to the type of implant overdentures.The appropriate choices and conduction of the above-mentioned procedures can guarantee the long-term success of the prostheses.This review elaborates on the clinical significance,treatment design,key steps in clinical procedure of implant overdenture,and summarizes follow-up and maintenance following denture delivery.