压膜保持器对种植单冠近中邻间隙的影响及患者接受度调查

Effect of vacuum-formed retainer on the mesial proximal contact gap of the implant supported crown and investigation of patient acceptability

目的:探讨压膜保持器对后牙区种植单冠近中邻间隙的影响,并对患者接受度进行调查。方法:纳入后牙区种植单冠修复患者167例,牙冠平均戴用时间2.41年。以金属咬合纸和测力计评估邻间隙大小,对出现近中邻间隙及食物嵌塞的30例牙冠重新修复,嘱患者夜间戴用压膜保持器并每半年复查,随访到与第一次修复后相同的时间,比较未戴用与戴用压膜保持器时的种植单冠近中邻间隙大小,种植体周围指数与天然牙牙周指数,调查167例患者对压膜保持器的接受程度。结果:夜间戴用压膜保持器平均2.41年,30例种植单冠近中邻间隙明显小于未戴用压膜保持器时(P<0.05),食物嵌塞情况有所缓解。佩戴压膜保持器时种植体周围指数(PD,mSBI)优于食物嵌塞时(P<0.05),天然牙牙周指数(PD,BI)较佩戴前无明显变化。有夜磨牙或食物嵌塞的患者对压膜保持器接受度优于其他组别(P<0.05)。结论:夜间佩戴压膜保持器可能有助于减小种植单冠近中邻间隙,缓解食物嵌塞。对有夜磨牙或曾因邻间隙反复食物嵌塞的患者可有针对性地推荐使用。

Objective:To evaluate the effect of the vacuum-formed retainer(VFR)on the control of the mesial proximal gap of implant-supported crown,and to investigate the acceptability in patients.Methods:167 patients with single posterior implant-supported crown after a mean time of 2.41 years observation were included.Proximal contact was evaluated by shim stock films(12-μm-thick)and custom-made dynamometer.Thirty implant crowns(in 29 patients)were found out mesial proximal gap and food impaction.The proximal contact of the 30 crowns were reestablished,and the 29 patients were asked to wear VFRs at night.Reviewed at each 6 months until reached the same time with the first monitoring lengths.The mesial proximal gap of each crown with and without VFR were compared,and the periodontal and peri-implant indexes were also evaluated.The acceptability of VFRs in 167 patients was investigated by VAS.Results:After wearing VFRs at night for an average of 2.41 years,the mesial proximal gap of 30 implant crowns were significantly narrower than that without wearing VFR(P<0.05),and food impaction was alleviated.The peri-implant index(PD,mSBI)with VFR was better than that with frequent food impaction(P<0.05),and the periodontal index(PD,BI)did not change significantly.The acceptability of VFRs in patients with bruxism or proximal contact loss accompanied with food impaction was higher than the other groups(P<0.05).Conclusion:For the reconstructed mesial proximal contact sites of implant crown in posterior region,night-time wearing VFR had a positive effect on the control of proximal gap in the short-term observation,which might alleviate food impaction and improve the peri-implant condition.For patients with bruxism or recurrent food impaction because of open proximal contact,VFR may be accepted as a choice.