下颌远端延伸可摘局部义齿-基牙应力分析及牙槽骨高度变化。

H. Wageh, A. Mm, Salah A. Hegazy, Mostafa Az
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引用次数: 0

摘要

目的:研究双臂卡环作为双侧下颌远端可摘局部义齿固位单元的作用:研究应力分析对基牙(离体)和基牙牙槽骨高度变化(体内)的影响。固定卡扣包括:反环卡扣和改进的半-半卡扣组件。材料与方法:体外研究:采用三种框架不同固位单元的RPD远端延伸模型进行应力分析。活体研究:在一项随机对照临床试验中,15例上颌完全无牙和下颌剩余8颗前牙包括第一前磨牙。他们被随机分为三组。所有患者均采用上颌全口义齿。第一组:远端延伸RPD设计反向环形卡环。II组:远端延伸RPD设计为改良的半卡环总成,不带远端咬合托,前咬合托产生固位卡环臂。III组:远端延伸RPD设计为改良的半卡环和半卡环总成,不带远端咬合支架,改良的固定卡环臂由近端引导板产生。在义齿植入后、植入后6个月和植入后12个月,通过数字根尖周x线片对基牙进行放射学评价。结果:I组(反环卡环)与II组和III组(改良半-半卡环组合)相比,基台骨吸收明显增加。从应力角度看,双侧加载组I对基台施加的应力大于II组和III组。结论:改良半-半卡环组(应力释放卡环组)对远端伸展病例基牙牙槽骨吸收效果优于反环卡环组。反向环扣(组I)不纯粹的压力释放,对于用于此目的的双臂扣。从传递应力的角度来看(双侧载荷),改良的半-半卡环装配(II组)传递到基牙的应力比III组少,这是本研究(体外)获得的结果,与I组到II组和III组相比,可以最大限度地减少基牙牙槽骨吸收。本研究建议应用一种新的应力释放卡环设计用于远端延伸RPD(改进的半-半卡环组件,如第II组和第III组)。这些组件应通过分离添加到应力释放作用的固定单元中。
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Double-Arm Clasp with Anterior Placed Occlusal Rest Retained Mandibular Distal Extension Removable Partial Denture - Stress Analysis and Alveolar Bone Height Changes of Abutments.
Aim: study the effect of double-arm clasps as retainer units for bilateral mandibular distal extension removable partial denture regard: Study of stress analysis applied on the abutments (in-vitro) and abutment alveolar bone height changes (in-vivo).The retainer clasps includes: Reverse circlet clasp and Modified Half-and-Half clasp assembly. Materials and methods: In-vitro study: Model RPD distal extension with three frameworks of different retainer units for stress analysis. In-vivo study: In a randomized controlled clinical trial, fifteen patients with completely edentulous maxilla and remaining mandibular eight anterior teeth including 1st premolar. They were randomly divided to three groups. All patients received maxillary complete denture. Group I: where distal extension RPD designed with Reverse circlet clasp. Group II: where distal extension RPD designed with modified halfandhalf clasp assembly without distal occlusal rest and retentive clasp arm arising from anterior occlusal rest. Group III: where distal extension RPD designed with modified Half and Half clasp assembly without distal occlusal rest and modified retentive clasp arm arising from proximal guiding plate. The abutment tooth was evaluated radio graphically by digital periapical radiographs after insertion, after 6 months and after 12months after denture insertion. Results: Group I (Reverse circlet clasp) significant increase in bone resorption of abutment compared to those in Group II and Group III (modified half-and-half clasp assembly). From stress point of view, in bilateral loading group I applied more stress to abutment compared to group II and III. Conclusion: Group II &III modified half-and-half clasp assemblies (stress releasing clasp assembly) superior to reverse circlet clasp regard to abutment alveolar bone resorption of distal extension cases. Reverse circlet clasp (Group I) not purely stress releasing by disengagement regarding double arm clasp utilize for this purpose. From stress transmitted point of view (bilateral loading), modified half-and-half clasp assembly (group II) exhibit less stresses transmitted to the abutment than exhibit in group III as a result obtained in this study (in-vitro) that minimize abutment alveolar bone resorption compared to group I to group II& III. This research recommends the application of a new stress releasing clasp designs for distal extension RPD (modified halfand-half clasp assemblies as in group II & III). These assemblies should be added to retainer units of stress releasing action by disengagement.
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