数字全弓种植体支持的聚甲基丙烯酸甲酯临时假体:一项基于实践的生存和生活质量队列研究。

Carlota Mendonça, Diana de Macedo, Carlos Nicolai, Hugo Madeira, Eric Van Dooren, David Norré, António Mata
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摘要

目的:与传统的丙烯酸假体相比,数字规划和制造的用于全弓种植体支撑的即时加载临时假体的PMMA正变得越来越流行。关于修复性能和患者相关结果的研究很少,但仍有必要。本研究的目的是评估即刻负载植入物支持的全弓CAD-CAM研磨PMMA临时康复的临床生存率和对口腔健康相关生活质量的影响。方法:这是一项在葡萄牙牙科诊所进行的基于实践的前瞻性队列研究。11名患者共接受了17例CAD CAM全种植体支持、螺钉保留、铣削PMMA全足弓康复,并随访了1年。主要结果是通过修改加州牙科协会评分和Kaplan-Meyer生存功能分析确定假体生存率。次要结果是通过应用OHIP 14 PT问卷和两次就诊之间的标准化效应大小变化来定义患者的生活质量。结果:12个月生存率为76%,假体完全骨折发生率为17.6%,无实验室介入的小骨折发生率5,9%。在第1次就诊和第4次就诊之间,口腔健康相关的生活质量有了显著改善。OHIP-14 PT总分的平均差异和影响大小分别为-32.91(±3.68 SD)和3.66(95%CI-1.83至-5.80)P<0.001*Wilcoxon配对秩检验。结论:全弓种植体支持CAD-CAM铣削PMMA临时假体是一种可行的方法,具有良好的生存率,对患者口腔健康相关的生活质量有很大影响。
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Digital Full-Arch Implant-Supported Polymethyl Methacrylate Interim Prosthesis: A Practice-Based Cohort Study on Survival and Quality of Life.

Purpose: To evaluate the clinical survival and impact on oral health-related quality of life (OHRQoL) of immediate loading of implant-supported full-arch CAD/CAM-milled PMMA interim restorations.

Materials and methods: This was a practice-based prospective cohort study performed in a Portuguese dental clinic. Eleven patients received a total of 17 CAD/CAM fully implant-supported, screw-retained, full-arch restorations with milled PMMA and were followed up for 1 year. The primary outcome was prosthesis survival, determined with a modification of the California Dental Association score and a Kaplan-Meier survival function analysis. The secondary outcome was the patient quality of life, as defined by application of the OHIP-14-PT questionnaire and standardized effect size variation between two visits. Significance was set at 5%.

Results: Survival probability at 12 months was 76%, complete fracture of the prosthesis occurred in 17.6% of the cases, and small fractures without lab involvement occurred in 5.9% of cases. There was a significant improvement in OHRQoL between visit 1 and visit 4. The mean difference and effect size for total OHIP-14-PT score were -32.91 ± 3.68 and 3.66 (95% CI -1.83 to -5.80) respectively (P < .001* Wilcoxon matched paired rank test).

Conclusions: Fullarch implant-supported CAD/CAM-milled PMMA interim prosthesis seem to be a viable approach with good survival rate and great impact on patient OHRQoL.

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