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修正模型印模技术对模型游离端形态及义齿修复效果的影响

隋磊1,刘红红1,余培1,高平2   

  1. 1. 天津医科大学口腔医学院口腔医院
    2. 天津医科大学口腔医院
  • 收稿日期:2013-08-22 修回日期:2013-12-16 出版日期:2014-04-15 发布日期:2014-04-15
  • 通讯作者: 隋磊

Influence of the Altered-Cast Impression Technique on Distal-Extension Alveolar Ridge Morphology and Restorative Result

  • Received:2013-08-22 Revised:2013-12-16 Published:2014-04-15 Online:2014-04-15
  • Contact: Lei SUI

摘要:

【摘要】目的 探讨修正模型印模技术对肯氏Ⅰ、Ⅱ类牙列缺损模型游离端牙槽嵴形态及可摘局部义齿(RPD)修复效果的影响。方法 选择54例下颌肯氏Ⅰ、Ⅱ类牙列缺损患者。采用修正模型印模法及常规印模法分别为同一患者取模;将模型游离端由远中至近中逐层进行冠状横截面扫描;比较图像形态差异,并分析该差异与横截面位置之间的关系。将患者按配对设计均分为2组,分别采用修正模型印模技术和常规印模技术取模制作RPD;比较2 组患者适应期的调改次数、适应期结束后义齿咀嚼是否有力、咀嚼时游离端基托是否存在肉眼可见动度。结果 修正模型印模法及常规印模法所获模型同一横截面图像像素数差异有统计学意义(P<0.01),前者小于后者;像素数差值D与切磨次数N(横截面位置)之间呈负相关;修正模型组适应期调改次数(次:1.12±0.77vs3.41±0.82)、游离端基托存在肉眼可见动度阳性率低于常规模型组(0 vs18.5%),调改后义齿咀嚼有力阳性率高于常规模型组(96.3% vs 74.1%)。结论 采用修正模型印模技术所获模型的游离端牙槽嵴形态与常规印模法所获模型有明显差异,距末端基牙远中面越远差异越大;采用该技术取模制作的RPD修复效果优于采用常规印模技术制作者。

关键词: 修正模型印模技术, 远中游离端, 牙列缺损, 可摘局部义齿

Abstract:

[Abstract] Objective To investigate the impact of the modified cast impression technique on distal-extension alve? olar ridge morphology of partially edentulous casts and the restoration outcome of removable partial dentures (PRDs).Meth? ods Fifty-four patients with mandibular free-end dentition defect were selected. Impressions were taken from each patient using both modified cast technique and conventional technique. Coronary cross-sections of the casts were scanned from dis? tal to mesial extension; the images were compared to reveal morphological differences. And the relationship between these differences and location of the cross- sections were analyzed. After the patients were evenly divided into two groups per paired design, the impressions were taken using the respective modified cast and conventional impression techniques to pre? pare RPDs. The subsequent comparisons between the two groups included frequency of adjustments during the adaptive phase, masticatory efficiency of the denture at ending of the adaptivephaseand visible movement of the extension base dur? ing mastication. SPSS 16.0software was used for statistical analysis. Results The number of pixels in the same cross-sec? tion was less in the impression taken with modified cast technique than that with conventional technique. And their differ? ence is of statistical significance (P<0.01). The difference in the number of pixels (D) was negatively correlated with the number of cutting and grinding, and N (location of the cross-sections). In addition, there were statistically significant differ? ences in frequency of adjustments during theadaptivephase(times:1.12±0.77vs3.41±0.82), masticatory efficiency of the denture (0vs18.5%) and visible movement of the extension base during mastication (96.3%vs74.1%) between the modified cast group and conventional group.Conclusion Morphology of distal-extension alveolar ridge of the casts differs signifi? cantly between the impressions obtained with modified cast technique and the impressions obtained with the conventional technique; the difference increases with greater distance to the distal surface of the terminal abutments. The restoration out? come of RPDs is significantly better with the modified cast impression technique than with the conventional impression tech? nique.

Key words: altered cast impression technique, distal-extension, partially edentulous, removable partial denture