应用不同类型附着体的下颌种植覆盖义齿的系统评价  

Attachments for Mandibular Implant-supported Overdenture: A Systematic Review

作　　者：杜莉[1] 黄韦[1] 杨准[1] 

机构地区：[1]四川大学华西口腔医学院修复科,成都610041

出　　处：《中国循证医学杂志》2006年第9期667-672,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的评价使用不同类型附着体的下颌种植覆盖义齿的临床结果、患者满意度和修复后维护情况。方法计算机检索the Cochrane Central Register of Controlled Trials (CENTRAL,2005年第4期)、Current Controlled Trials、MEDLINE (1966～2005．9)、EMBASE(1984～2005．9)和中国生物医学文献光盘数据库(1978～2005．9),并手检11种中文口腔医学期刊。由3位作者参与文献筛选、资料提取和质量评价,并对合格研究进行描述或Meta分析。结果共有12篇文献符合纳入标准,共计282位患者,其中杆-卡式附着体组154例,球-帽式附着体组116例,磁性附着体组12例。对其中2个研究进行了Meta分析(杆-卡式附着体组27例、球-帽式附着体组29例),对不能进行Meta分析的研究作了全面的描述。已有的研究似乎表明:杆-卡式附着体固位力强但口腔粘膜并发症较多;球-帽式附着体的固位力较强且口腔粘膜并发症较少,但其种植修复后维护次数较多;磁性附着体固位力较弱但其种植体周状况可能较好。结论在上述3种不同附着体应用于下颌覆盖种植义齿的选择方案中,目前尚无足够证据表明哪一种是最佳选择;仍需开展更多的随机对照试验,应用精确客观的指标来综合判断对于下颌覆盖种植义齿应如何选择不同类型的附着体。Objective To evaluate clinical outcomes, patient satisfaction, and maintenance after treatment from mandibular implant-supported overdentures with different attachment types. Methods We searched six electronic databases： the Cochrane Central Register of Controlled Trials （CENTRAL, The Cochrane Library, Issue 4, 2005）, Current Controlled Trials, MEDLINE （1966 to Sept. 2005）, EMBASE （1984 to Sept. 2005）, and Chinese biomedical database disk （1978 to Sept. 2005）. Eleven Chinese professional journals in oral health were also handsearched from their first published issues. Three authors screened and selected the studies, appraised their methodological quality and extracted data from the studies. The results were presented narratively by meta-analysis. Results After strict screening, 12 trials involving 282 patients were included. Two of the trials were included in a meta-analysis with 27 patients in bar-clip group, 29 patients in ball-spring group, and the other trials were described thoroughly. The findings seemed to indicate that the bar-clip group had the highest retention but more oral mucosa complications, while the ball-spring group had good retention and less oral mucosa complications but needed more aftercare treatments, and the magnetic group had less retention but better peri-implant outcomes. Conclusions There is inadequate evidence to prove which is the best choice for mandibular implant-supported overdentures among bar-clip, ball-spring and magnetic attachments. More controlled clinical trials are required to guide clinicians on the choice of the type of attachment in mandibular implant-supported overdenture.

关 键 词：附着体 下领种植覆盖义齿 系统评价 

分 类 号：R783[医药卫生—口腔医学]