下颌球帽覆盖义齿与全口义齿戴用2~3年咬合特征研究

目的研究下颌球帽附着体固位覆盖义齿（COD）及全口义齿（CD）修复后2~3年咬合接触特征及差异。 方法采用T-ScanⅡ咬合分析仪对戴用2~3年CD及COD修复患者（各12例）进行体内咬合分布特征及 力升高时间的测定。记录患者义齿左右侧咬合面积不对称指数、咬合力中心（X,Y）值、咬合力前后向分布比率及 力升高时间。 结果（1）CD组、COD组左右侧咬合面积不对称指数、咬合力中心X值,差异无统计学意义（P > 0.05）;（2）COD组咬合中心前移,差异有统计学意义（P < 0.05）;（3） 力升高时间CD组0.28 s,COD组延长为0.59 s,差异有统计学意义（P < 0.05）。 结论正中咬合时,CD戴用2~3年咬合分布、 力升高时间近似正常 ,COD咬合中心向基牙区偏移, 力升高时间延长。     

The implant-supported overdenture as an alternative to the complete mandibular denture

BACKGROUND: Approximately one-third of Americans older than 65 years of age are fully edentulous, requiring replacement of missing teeth. While the conventional denture may meet the needs of many patients, others require more retention, stability, function and esthetics, especially in the mandible. The implant-supported prosthesis is an alternative to the conventional removable denture. METHODS: This article describes the strengths of the implant-supported mandibular overdenture. The authors also outline the risks of this approach. They performed a review of recent literature to summarize the reported success rate of implants used to support a mandibular overdenture. RESULTS: The literature review indicates that implants placed in the anterior mandible (anterior to the foramen) have a success rate better than 95 percent. Patients have reported a high degree of satisfaction with the implant-supported overdenture. CONCLUSIONS: The literature indicates that implant-supported overdentures in the mandible provide predictable results with improved stability, retention, function and patient satisfaction compared with conventional dentures. Implants placed in the anterior mandible have a success rate equal to or greater than 95 percent. CLINICAL IMPLICATIONS: When planning treatment for patients with edentulous mandibles, clinicians should consider the implant-supported prosthesis.     

The mandibular complete overdenture

Mandibular complete overdenture treatment has been available for decades, but its use was limited when the treatment relied on retained teeth as overdenture abutments. This treatment, however, is currently experiencing more popularity than ever before. In fact, dentistry may be experiencing a philosophical shift, in which mandibular implant overdenture treatment may become the new standard of care for the treatment of the edentulous mandible. Practitioners are looking for simplified treatments that can provide cost-effective alternatives to more complex implant prosthodontic procedures. Implant overdentures provide a strong return for the investment in treatment time and expense and are a treatment suited to the lower socioeconomic status of many edentulous patients. The clinical outcome of this treatment is significantly better than that achieved with conventional mandibular dentures, especially when patients are experiencing technical problems because of compromised prosthesis retention or stability.     

The mandibular swing-lock complete denture for patients with microstomia.

Regardless of cause, the treatment of an edentulous patient with microstomia is difficult and often ingenious. Prosthodontic treatment modalities previously described are reviewed. A new type of prosthesis, the collapsible mandibular swing-lock complete denture, is introduced. The prosthesis incorporates a cast cobalt-chromium framework with a lingual hinge and a conventional labial swing-lock. This combination allows the prosthesis to be collapsible while maintaining structural durability. Advantages include ease of insertion and removal while providing maximum coverage for support, retention, and stability. A stepwise technique for the clinical and laboratory phases is described.     

下颌磁性附着体覆盖全口义齿的临床疗效观察

目的：调查磁性附着体覆盖全口义齿修复的临床效果。方法：对9例磁性附着体患进行义齿满意度问卷调查分析，并检查患基牙临床指征及牙周微生态的情况。结果：患对磁性附着体义齿固位稳定功能满意度最高；基牙的微生物组成与正常值相比有一定的变化，但戴牙前后基牙临床指标无明显变化。结论：适当的修复以及良好的口腔卫生条件下，下颌磁性附着体覆盖全口义齿是一种有效、可行的修复方式。     

Hinged mandibular removable complete denture for post-mandibulectomy patients.

The presence of excessive lingual undercuts after mandibulectomy and surgical reconstruction is a rare clinical condition and presents unique prosthodontic challenges. The goals of prosthodontic treatment include: providing lip support, improving articulation, reducing drooling, and regaining favorable esthetics. This article describes the fabrication of a hinged removable mandibular complete denture prosthesis using a sectional impression tray technique and a custom-made hinge mechanism. Clinical and laboratory procedures of the prosthetic treatment are described, and the advantages and disadvantages are reviewed.     

下颌磁性附着体覆盖全口义齿患者满意度调查

目的调查患者对磁性附着体覆盖全口义齿临床效果的满意度。方法采用全口义齿满意度问卷对9例磁性附着体义齿患者进行调查分析并观察基牙临床情况。结果患者对磁性附着体义齿固位、稳定、咀嚼功能、语音功能、外观、舒适性、坚固性均较满意,以固位、稳定、外观的满意度为高;戴牙前后基牙的临床指标无明显变化。结论下颌磁性附着体覆盖全口义齿修复有效、可行。     

FRIALIT-2球帽固位种植覆盖义齿修复低平下颌牙槽嵴的疗效观察

目的：评价FRIALIT-2球帽固位的种植覆盖义齿修复下颌牙列缺失且牙槽嵴低平的临床效果。方法：将6例下颌牙列缺失且牙槽嵴低平的患者植入2颗FRIALIT-2种植法，利用FRIALIT-2球帽附着体固位制作覆盖义齿，进行12-24个月的临床追踪。结果：覆盖义齿的固位及使用效果均满意，种植体周围骨高度第一年平均降低0.8mm，有4颗种植体周围粘膜红肿，有3例患者需要重衬，有2例患者覆盖义齿折断，结论：球帽固位种植覆盖义齿是下颌牙列缺失且牙槽嵴低平者有效修复方式。     

覆盖义齿修复方式保留重度牙周病口内余留牙的远期效果

目的观察重度牙周病口腔内余留牙体部分切除后,以覆盖义齿方式保留的远期效果。方法 追踪检查2001～2006年内采用不同覆盖义齿方式保留下来的基牙141颗,临床检查覆盖义齿的基本使用状况,测定口腔内剩余牙炎症程度、牙松动度和咀嚼效能,进行对比分析。结果基牙牙龈炎症消退,牙周炎得到一定控制,松动度普遍有一定缓解,义齿咀嚼功能良好,其中疗效Ⅰ级109颗,Ⅱ级20颗,Ⅲ级12颗。结论选用适当的覆盖义齿方式保留重度牙周病的牙体远期疗效是肯定的。     

A cost comparison of mandibular two-implant overdenture and conventional denture treatment

Purpose

This article compares the cost of mandibular two-implant overdenture treatment to that of conventional denture treatment in an academic teaching hospital.

Materials and Methods

Sixty edentulous patients (aged 65 to 75 years) participated in a randomized clinical trial. All patients received a new maxillary complete denture and either a mandibular conventional denture (n=30) or an implant overdenture on two unsplinted implants (n=30). Resource-based microcosting of direct and indirect costs (eg, expenses and time cost to patients) of all scheduled and unscheduled visits was conducted through 1 year following delivery of the prostheses.

Results

Mean direct costs (1999 CD dollars) for scheduled visits in the implant and conventional groups were 2,332 dollars and 814 dollars, respectively, and mean indirect costs were 1,150 dollars and 810 dollars, respectively. Differences between the two groups were significant. Twenty-six patients in each group had unscheduled visits during the study at a median direct cost for the overdentures of 85 dollars and 64 dollars for the conventional dentures. Median indirect costs for unscheduled visits were 163 dollars and 202 dollars, respectively. These differences were not significant. Mean total costs of the overdentures were 4,245 dollars and 2,316 dollars for the conventional dentures, and the between-group difference was significant.

Conclusion

The direct cost of mandibular two-implant overdenture treatment was 2.4 times higher than that of conventional denture treatment. When indirect costs were added, the implant-to-conventional total cost ratio estimate was 1.8. These cost data can now be combined with estimates of the efficacy of the two types of prosthesis so practitioners and patients can make informed decisions about these prosthodontic treatment concepts.     

A cost comparison of mandibular two-implant overdenture and conventional denture treatment

PURPOSE: This article compares the cost of mandibular two-implant overdenture treatment to that of conventional denture treatment in an academic teaching hospital. MATERIALS AND METHODS: Sixty edentulous patients (aged 65 to 75 years) participated in a randomized clinical trial. All patients received a new maxillary complete denture and either a mandibular conventional denture (n = 30) or an implant overdenture on two unsplinted implants (n = 30). Resource-based microcosting of direct and indirect costs (eg, expenses and time cost to patients) of all scheduled and unscheduled visits was conducted through 1 year following delivery of the prostheses. RESULTS: Mean direct costs (1999 CD dollars) for scheduled visits in the implant and conventional groups were 2,332 dollars and 814 dollars, respectively, and mean indirect costs were 1,150 dollars and 810 dollars, respectively. Differences between the two groups were significant. Twenty-six patients in each group had unscheduled visits during the study at a median direct cost for the overdentures of 85 dollars and 64 dollars for the conventional dentures. Median indirect costs for unscheduled visits were 163 dollars and 202 dollars, respectively. These differences were not significant. Mean total costs of the overdentures were 4,245 dollars and 2,316 dollars for the conventional dentures, and the between-group difference was significant. CONCLUSION: The direct cost of mandibular two-implant overdenture treatment was 2.4 times higher than that of conventional denture treatment. When indirect costs were added, the implant-to-conventional total cost ratio estimate was 1.8. These cost data can now be combined with estimates of the efficacy of the two types of prosthesis so practitioners and patients can make informed decisions about these prosthodontic treatment concepts.     

Symptoms of mandibular dysfunction in complete denture wearers

Recent epidemiological studies have shown that symptoms of mandibular dysfunction are very common, but prosthodontists have thought that complete denture wearers are spared such complications. However, in recent reported series of patients who have sought advice for mandibular dysfunction complete denture wearers have been included. According to epidemiological data individuals with few remaining natural teeth had more symptoms of dysfunction than those with most of their natural teeth, and complete denture wearers had more symptoms of mandibular dysfunction than subjects with natural teeth. Mandibular and temporomandibular joint dysfunction symptoms have a heterogeneous background, but occlusal instability is an important aetiological factor. In complete denture wearers with mandibular dysfunction, symptoms often disappear after improvement of the occlusion.     

冲击载荷下骨外段种植基桩不同高度对下颌覆盖总义齿应力分布的影响

目的 分析骨外段种植基桩高度不同对下颌种植覆盖总义齿应力分布的影响。方法 应用ＣＴ扫描法建立下颌种植覆盖总义齿三维有限元模型,分析冲击载荷下骨外段种植基桩高度不同对下颌种植覆盖总义齿应力分布的影响。结果 随种植基桩高度的降低,种植体内部及种植体软硬组织界面应力分布更为均匀。结论 在保证义齿固位稳定的前提下,在一定范围内降低种植体骨外段基桩高度有利于保护种植体及其周围软硬组织健康。     

下颌磁性附着体覆盖全口义齿基牙龈沟内细菌的研究

目的 :了解磁性附着体基牙龈下微生物组成与正常龈下微生物组成比的差异及卫生指导前后基牙龈下微生物数量及组成的改变。方法 :检测卫生指导前后磁性附着体患者基牙以及正常人群相对应牙位龈下检出可培养微生物总量及组成比的变化。结果 :下颌磁性附着体覆盖全口义齿基牙龈沟中 ,G-杆菌及牙周炎相关细菌 ,如放线菌和其它不产黑色素G-杆菌组成较正常牙周增多 ,组成比为 19.2 3 %± 7.5 9%和 11.61%± 9.89% ;在卫生指导前后 ,基牙牙周龈沟内细菌的总量有所下降 ,而细菌的组成比没有明显变化。结论 :戴用下颌磁性附着体覆盖全口义齿是牙周炎的易感人群 ,但正确的卫生指导对基牙牙周细菌的控制有一定的效果