Jin-Hong Park^1,2,*; Jeong-Yol Lee^1,2; Sang-Wan Shin²

¹Prosthodontics, Korea University Guro Hospital; ²Institute for Clinical Dental Research, Seoul, South Korea

Background: The implant-assisted removable partial dentures (RPDs) have been proposed as an alternative option to complement the limitations of the conventional RPDs improving posterior support by implant placement in distal extension areas. As the implant is required to improve denture base support, a magnet attachment might be more suitable for implant-assisted RPDs due to direct metal contact between matrix and patrix parts compared with a healing abutment or a stud attachment using a resilient insert

Aim/Hypothesis: This study was compared treatment outcomes of magnet attachments to stud attachments on implant-assisted RPDs, in terms of patient satisfaction (mastication, pronunciation, esthetics, pain, and general satisfaction), implant success rate (ISR), and peri-implant marginal bone loss (MBL).

Material and Methods: Thirty-two participants with mandibular distal extended partially edentulous dentition were included in this randomized controlled trial. In each posterior edentulous area, one implant was placed 3 months after insertion of new conventional RPDs (T_CRPD). Six months after implant placement, an implant-assisted RPD with either a magnet attachment or a stud attachment (CM-LOC attachment) was completed (T₀). Data of patient satisfaction using visual analogue scale (VAS) were collected in T_CRPD, 3 (T₃) and 12 months (T₁₂) after implant loading. ISR and MBL were assessed during 12 months after definitive prosthesis delivery based on the clinical and radiological examination. The VAS patient satisfaction values were analyzed using repeated-measures ANOVA between the three measurement time points (T_CRPD, T₃, and T₁₂). VAS value, ISR, and MBL were analyzed using independent t-test between the two groups and the risk factors related the MBL were analyzed by multivariate regression analysis.

Results: Thirty of the thirty-two patients completed the 1-year follow-up and had their treatment outcomes evaluated. Compared to T_CRPD, patient satisfaction was improved in pain and general satisfaction at T₃, and all of 5 detailed items including mastication, esthetics, and pronunciation at T₁₂ (p < 0.05). Magnet group showed higher patient satisfaction in terms of mastication and esthetics at T₁₂ compared to stud group (p < 0.05). During 12-months follow-up period, ISR per implant was 94.34% (50/53 implants), ISR per patient 90% (27/30 patients), and MBL -0.59 ± 0.77 mm, and there was no statistical difference between attachment system. As a result of multiple linear regression analysis, an increase of 1 mm in implant diameter correlated with a 1.09 mm reduction in MBL (p < 0.05)

Conclusion and Clinical implications: Within the limitations of this study, implant-assisted RPDs provide significant improvement of patient satisfaction than conventional RPDs and predictable results in clinical and radiological evaluation. The magnet attachment and wider diameter implants within the anatomically allowable limits could be considered to improve treatment outcomes (higher patient satisfaction and lower peri-implant marginal bone loss) in implant-assisted RPDs cases.

Disclosure of Interest: None Declared

Keywords: clinical studies/trials, implant stability, patient satisfaction

金红公园^1,2,* ; 李正烈^1,2 ; 新上完²

¹高丽大学九老医院口腔修复科；²韩国首尔临床牙科研究所

背景：种植体辅助可摘局部义齿 (RPD) 已被提议作为替代选择，以补充传统 RPD 的局限性，通过将种植体放置在远端延伸区域来改善后部支撑。由于需要种植体来改善义齿基托的支撑，与愈合基台或使用弹性嵌件的螺柱附件相比，磁铁附件可能更适合种植体辅助的 RPD，因为基体和基牙部分之间有直接的金属接触

目的/假设：本研究在患者满意度（咀嚼、发音、美学、疼痛和总体满意度）、种植成功率 (ISR) 和种植体辅助 RPD 上比较了磁铁附件与螺柱附件的治疗结果。 - 种植体边缘骨丢失 (MBL)。

材料和方法：本随机对照试验包括 32 名下颌远端部分无牙列延伸的参与者。在每个后牙缺牙区，在插入新的传统 RPD (T _CRPD ) 3 个月后植入一个种植体。种植体植入六个月后，完成了带有磁铁附件或螺柱附件（CM-LOC 附件）的种植体辅助 RPD (T ₀ )。在 T _CRPD、3 (T ₃ ) 和 12 个月 (T ₁₂) 种植体加载后。ISR 和 MBL 在最终假体交付后的 12 个月内根据临床和放射学检查进行评估。使用重复测量方差分析在三个测量时间点（T _CRPD、T ₃和 T ₁₂）之间分析 VAS 患者满意度值。两组间采用独立t检验分析VAS值、ISR、MBL，多元回归分析与MBL相关的危险因素。

结果： 32 名患者中有 30 名完成了 1 年的随访并评估了他们的治疗结果。与 T _CRPD相比，患者在 T _{3 时的}疼痛和总体满意度以及 T _{12 时的}咀嚼、美学和发音等 5 个详细项目的满意度均有所提高（p < 0.05）。与螺柱组相比，磁铁组在 T _{12 时}的咀嚼和美学方面表现出更高的患者满意度（p< 0.05)。在12个月的随访期间，每个种植体的ISR为94.34%（50/53个种植体），每个患者的ISR为90%（27/30个患者），MBL -0.59 ± 0.77 mm，附着体之间没有统计学差异系统。作为多元线性回归分析的结果，种植体直径增加 1 毫米与 MBL 减少 1.09 毫米相关 ( p < 0.05)

结论和临床意义：在本研究的局限性内，种植体辅助 RPD 与传统 RPD 相比显着提高了患者满意度，并在临床和放射学评估中提供了可预测的结果。在植入物辅助 RPD 病例中，可以考虑在解剖学允许范围内使用磁铁附件和更宽直径的植入物来改善治疗结果（更高的患者满意度和更低的种植体周围边缘骨质流失）。

利益披露：无申报

关键词：临床研究/试验，种植体稳定性，患者满意度