中老年无牙颌患者在种植固定义齿和种植覆盖义齿修复后1~3年临床疗效对比

周子谦; 李淑媛; 倪璨

doi:10.16766/j.cnki.issn.1674-4152.002804

中老年无牙颌患者在种植固定义齿和种植覆盖义齿修复后1~3年临床疗效对比

doi: 10.16766/j.cnki.issn.1674-4152.002804

南京大学医学院附属口腔医院种植科, 江苏南京 210000

基金项目:

国家自然科学基金青年基金项目 82001051

详细信息

通讯作者:
周子谦，E-mail: Zzq5042@hotmail.com

中图分类号: R783.6
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- 被引次数: 0
出版历程
- 收稿日期: 2022-07-08
- 网络出版日期: 2023-04-07

Comparison of clinical efficacy of implant-supported fixed denture and implant-supported overdenture in middle-aged and elderly edentulous patients 1-3 years after final restoration

Dental Implantology Department, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210000, China

摘要

摘要: 目的比较中老年患者在分别完成无牙颌种植固定义齿(ISFP)或种植覆盖义齿(IOD)1~3年后种植体周围软硬组织、患者满意度和义齿并发症情况。方法选取2019年3月—2021年3月在南京大学医学院附属口腔医院就诊的43例中老年全口或半口无牙颌患者(50~80岁)，根据患者的治疗情况分为2组，一组为种植固定义齿修复(ISFP组，28例)，另一组为种植覆盖义齿修复(IOD组，15例)，完成最终修复治疗后1~3年进行随访。对2组患者的修复后软硬组织变化等进行评估和对比。结果 ISFP和IOD组患者在最终修复后1~3年种植体周围的软硬组织指标差异无统计学意义。ISFP组患者在修复后1~3年对义齿的固位力、咀嚼功能和语音功能的满意度显著高于IOD组，ISFP组分别为(9.179±0.700)分、(8.464±0.793)分、(8.179±0.772)分，而IOD组仅为(6.733±0.961)分、(6.467±0.915)分、(6.800±1.265)分，差异有统计学意义(均P＜0.05)，而对义齿的美观度和舒适度的评价2组差异无统计学意义。2组的机械并发症发生率差异无统计学意义。但是在机械并发症中，IOD组配件脱落或磨损发生率高于ISFP组，2组差异有统计学意义，2组的生物学并发症发生率差异无统计学意义。结论使用种植体支持的固定义齿和种植体支持的覆盖义齿均能够在一定范围内对无牙颌患者进行修复治疗，临床上要根据患者曾经的治疗情况和实际需要进行选择，同时也要考虑使用种植体支持的覆盖义齿可能存在后期较多并发症的可能。
- 无牙颌 /
- 种植固定义齿 /
- 种植覆盖义齿
Abstract: Objective To compare the soft and hard tissues around implants, patient satisfaction and denture complications of middle-aged and elderly edentulous patients after completing the implant supported fixed denture (ISFP) or implant supported overdenture (IOD) for 1-3 years respectively. Methods This study selected 43 middle-aged to elderly complete or partial edentulous jaws patients (between 50 and 80 years old) who were admitted in Nanjing Stomatological Hospital from March 2019 to March 2021. They were divided into two groups according to the clinical method of prosthesis. One group received implant supported fixed prosthesis (ISFP group, 28 cases), another group was treated with implant supported overdenture (IOD group, 15 cases), and the patients were followed up for 1-3 years after final restoration. The soft and hard tissue changes after repair were evaluated and compared between the two groups. Results There was no significant difference in the soft and hard tissue changes around the implants between the ISFP and IOD groups after treatment for 1-3 years. The ISFP group patients had achieved better denture retention, masticatory function, voice function and patients ' satisfaction compared to the IOD group 1-3 years after the treatments, the ISFP group was (9.179±0.700) points, (8.464±0.793) points, (8.179±0.772) points, while IOD group was only (6.733±0.961) points, (6.467±0.915) points, (6.800±1.265) points, and the difference was statistically significant (all P < 0.05), but there was no significant difference in the evaluation of the aesthetics and comfort level of dentures between the two groups. There was no significant difference in the incidence of mechanical complications between the two groups. However, in terms of mechanical complications, the incidence of parts shedding or wear in IOD group was higher than that in ISFP group, and the difference between the two groups was statistically significant, while the incidence of biological complications between the two groups was not statistically significant. Conclusion The application of implant-supported fixed prosthesis and implant-supported overdenture fit for edentulous patients in some certain circumstances. Clinically, we should choose the appropriate method according to the patients ' previous treatment conditions and willingness. The result that implant-supported overdentures may have more long-term complications should also be considered.
- Edentulous patients /
- Implant-supported fixed prosthesis /
- Implant-supported overdenture

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表 1 2组中老年无牙颌患者一般资料比较

Table 1. Comparison of general data between two groups of middle-aged and elderly patients with edentulous jaws

组别	例数	性别(例)		所治疗的颌位(例)			年龄(x±s，岁)	每单颌种植体数(x±s，颗)	吸烟(%)	义齿修复比例(%)	最终修复完成时间(x±s，年)
组别	例数	男性	女性	仅上颌	仅下颌	上下颌	年龄(x±s，岁)	每单颌种植体数(x±s，颗)	吸烟(%)	义齿修复比例(%)	最终修复完成时间(x±s，年)
ISFP组	28	17	11	11	11	6	62.250±6.586	4.821±0.819	39.3%(11/28)	25.0%(7/28)	2.254±0.453
IOD组	15	10	5	2	8	5	62.133±6.988	2.667±0.900	40.0%(6/15)	80.0%(12/15)	2.060±0.400
统计量		0.148^a		0.782^a			0.054^c	7.947^c	0.002^a	11.981^a	1.390^c
P值		0.700		0.096^b	0.377	0.473^b	0.957	0.001	0.964	0.001	0.172
注：^a为χ²值，^b为使用Fisher精确检验；^c为t值。

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表 2 2组中老年无牙颌患者修复后1~3年的临床指标比较

Table 2. Comparison of clinical indicators between two groups of middle-aged and elderly patients with edentulous jaws 1 to 3 years after restoration

组别	例数	种植体存留率(%)	牙周探诊深度(x±s, mm)	菌斑指数(x±s)	探针出血位点(x±s, %)	种植体边缘骨吸收量[M(P₂₅, P₇₅), mm]
ISFP组	28	100	3.771±0.799	1.941±0.234	40.9±14.4	0.285(-0.690, 2.408)
IOD组	15	100	3.740±0.730	1.827±0.255	49.3±12.3	1.271(-0.110, 2.120)
统计量			0.127^a	1.483^a	1.898^a	-0.357^b
P值			0.900	0.146	0.065	0.721
注：^a为t值，^b为Z值。

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表 3 2组中老年无牙颌患者修复后1~3年的患者满意度情况(x ±s，分)

Table 3. Satisfaction of middle-aged and elderly edentulous patients with edentulous jaws in two groups 1 to 3 years after restoration (x ±s, points)

组别	例数	固位力	咀嚼功能	发音功能	美观度	舒适度
ISFP组	28	9.179±0.700	8.464±0.793	8.179±0.772	7.750±0.752	7.929±0.764
IOD组	15	6.733±0.961	6.467±0.915	6.800±1.265	7.467±0.915	7.600±1.056
t值		9.779	7.462	4.446	1.092	1.172
P值		＜0.001	＜0.001	0.021	0.281	0.248

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表 4 2组中老年无牙颌患者修复后1~3年机械并发症发生情况比较

Table 4. Comparison of mechanical complications in two groups of middle-aged and elderly edentulous patients 1 to 3 years after restoration

组别	例数	崩瓷(例)	配件脱落/ 磨损(例)	配件折裂(例)	总计(例)	机械并发症发生率(%)
ISFP组	28	2	1	0	3	10.7
IOD组	15	0	4	1	5	33.3
P值		0.535	0.043	0.349	0.104
注：采用Fisher精确检验。

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表 5 2组中老年无牙颌患者修复后1~3年生物学并发症发生情况比较

Table 5. Comparison of biological complications between the two groups of patients 1-3 years after restoration

组别	例数	植体周黏膜炎(例)	植体周炎(例)	总计(例)	生物学并发症发生率(%)
ISFP组	28	1	0	1	3.6
IOD组	15	2	0	2	13.3
注：采用Fisher精确检验，2组并发症发生情况比较，P=0.275。

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