关键词:  , 种植修复体, 压膜保持器, 种植修复体邻接触丧失

Abstract: Objective： To evaluate the effect of the vacuum-formed retainer on preventing the proximal contact loss between the implant supported crown and its adjacent natural teeth. Methods: Fortysix posterior implant crowns in the mandible including 92 interproximal contacts in 46 patients (19 men, 27 women) aged from 25 to 66 years were included. The participants in experimental group (22 cases) were vacuum-formed retainers at night, while participants in control group (24 cases) only received routine examination. The two groups were not different in age, gender, the time interval of the tooth loss and tooth position at baseline. Mesial and distal proximal contact tightness was measured using the orthodontic dynamometer and metallic articulating film immediately after crown delivery, and 1-month, 3-month, 6-month, and 1-year follow-up respectively. The articulating film was inserted interdentally from the occlusal direction, and then it was slowly removed in the buccal-lingual direction by the dynamometer. Increasing the number of films (N) piece by piece until the frictional force (F) was great than 0, and the number of films (N) was recorded. At each follow-up, proximal contact between implant crown and its adjacent teeth was considered to be loss if the number of films (N) used at immediate crown delivery passed without frictional force (F=0). Besides, the periodontal conditions ［scored according to the probing depth (PD), bleeding index (BI), mobility (M)］ and complaint of food impaction were recorded. The mesial and distal proximal contact loss rates were compared between the two groups at different times. Chi-square test or Fisher’s exact test was used for statistical analysis. Results: The proximal contact loss rate on the mesial surface of the implant supported crown continuously increased over the follow-up pe-riods. At the end of the 1-, 3-, and 6-month follow ups, 18.2%, 22.7% and 27.3% were identified for the contact loss rates on the mesial surface of the implant supported crown in the experimental group, respectively. Meanwhile in control group, the rates were 20.8%, 37.5% and 45.8%. No significant differences were observed at the end of the 1-, 3-, and 6-month follow ups（1-month：χ2=0.000，P =1.000； 3-month： χ2=1.183， P=0.277； 6-month： χ2=1.697， P=0.193）. The proximal contact loss rate on the mesial surface in control group (62.5%) was significantly higher than that in the experimental group (31.8%, χ2=4.330, P=0.037) at the end of the 1-year follow-up. However, no statistical difference was found on the distal surfaces between the two groups during the whole follow-up periods. The first open contact was noted 1 month after crown insertion. Conclusion: By wearing vacuum-formed retainer for one year, the incidence of open contacts between the posterior implant prostheses and mesial adjacent teeth in the mandible has been reduced.

Key words: Dental implant restorations, Vacuum-formed retainer, Proximal contact loss adjacent to implant prostheses