Clinical performance of CAD-CAM-fabricated complete dentures: A cross-sectional study
Clinical performance of CAD-CAM-fabricated complete dentures: A cross-sectional study
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DOI：
10.1016/j.prosdent.2016.03.017
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发表时间：
2016-09-01
影响因子：
4.6
通讯作者：
McGlumphy, Edwin A.
中科院分区：
文献类型：
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作者：
Saponaro, Paola C.;Yilmaz, Burak;McGlumphy, Edwin A.
问题陈述。计算机辅助设计和计算机辅助制造 (CAD-CAM) 制造的全口义齿 (CD) 旨在解决与传统 CD 制造相关的缺点。然而，很少有随机临床试验、横断面和/或回顾性分析可用于 CAD-CAM 制造的 CD 的临床性能。这项回顾性研究的目的是评估临床医生在 2 次就诊方案中尝试制作数字 CD 的经验。记录并评估实际置入所需预约次数和置入后调整就诊次数，以及治疗并发症的发生率是否与操作者经验有关。材料和方法。通过回顾性图表审查确定接受过 CAD-CAM 制作 CD 的患者。计算了尝试该公司销售的 2 次就诊制造方案时插入数字 CD 所需的预约次数、插入后调整的次数以及报告的并发症。本研究中没有用于比较目的的对照组。操作者的经验水平是否影响并发症的发生频率、插入最终假体所需的预约次数以及插入后就诊的次数是通过使用在 95% 置信水平 (alpha=.05) 下评估的方差分析来确定的。使用精确的 Mantel-Haenszel 卡方检验分析了每个操作员经验级别的并发症发生频率。结果。在 48 名康复参与者中，24 名参与者接受了博士前级别的治疗，24 名参与者接受了口腔修复住院医师级别的治疗。共有 31 名参与者满足真正的 2 次就诊制造方案，其余 17 名参与者由于插入当天出现并发症而需要额外的临床就诊。样本人群中的 5 名参与者的 CD 假肢需要使用传统方法进行重制。插入后调整就诊的平均次数为 2.08 次。在已完成的 90 个牙弓中，有 22 个假体在第二次预约时无法插入。结论。两组中插入假肢所需的平均预约次数为 2.39 次，而不是该公司声称的 2 次。观察到的最常见并发症类型是义齿固位缺失、咬合垂直尺寸不准确以及中心关系不正确。
Statement of problem. Computer-aided design and computer-aided manufacture (CAD-CAM) fabricated complete dentures (CD) seek to address the disadvantages associated with conventional CD fabrication. However, few if any randomized clinical trials, cross-sectional, and/or retrospective analyses are available for the clinical performance of CAD-CAM-fabricated CDs.Purpose. The purpose of this retrospective study was to evaluate clinician experience with digital CD fabrication attempted in a 2-visit protocol. The actual number of appointments required for insertion and the number of postinsertion adjustment visits, and whether the incidence of treatment complications was related to operator experience were recorded and evaluated.Material and methods. Patients who had received CAD-CAM-fabricated CDs were identified from a retrospective chart review. The number of appointments needed to insert digital CDs in attempting the 2-visit fabrication protocol marketed by the company, the number of postinsertion adjustments, and the reported complications were counted. There was no control group for comparative purposes used in this study. Whether the experience level of the operator influenced the frequency of a complication, the number of appointments needed to insert the definitive prostheses, and the number of postinsertion visits was determined by using an analysis of variance assessed at the 95% confidence level (alpha=.05). The frequency of a complication at each of the levels of operator experience was analyzed using the Exact Mantel-Haenszel chi-square test.Results. Of the 48 rehabilitated participants, 24 participants were treated at the predoctoral level and 24 were treated at the graduate prosthodontics resident level. A total of 31 participants satisfied the true 2-visit fabrication protocol, and the remaining 17 participants required additional clinical visits because of complications on the day of insertion. The CD prostheses of 5 participants from the sample population required remaking using the conventional method. The mean number of postinsertion adjustment visits was 2.08. Of the 90 arches completed, 22 prostheses could not be inserted at the second appointment.Conclusions. The mean number of appointments needed to insert the prostheses in both groups was 2.39 visits not 2 as claimed by the company. The most common types of complications observed were lack of denture retention, inaccurate occlusal vertical dimension, and incorrect centric relation.