| Objective: 1.To quantitatively measure the proximal contact tightness between implant fixed denture and natural teeth,and study the influence of adjacent surface contact tightness on the incidence of food impaction.2.To explore the risk factors related to vertical food impaction of fixed implant denture,guide doctors to eliminate the risk factors in early stage and develop personalized treatment plan.Methods: According to the inclusion criteria and exclusion criteria,50 patients who received implant fixed dentures restoration in the Department of Prosthodontics of the First Affiliated Hospital of Dalian Medical University were selected.Questionnaire survey and oral examination were used to collect patients with food impaction and other relevant information.The questionnaire mainly collected the basic characteristics of patients,such as gender and age,as well as the location and time of incidence of food impaction.Oral examination is mainly about the contact relationship between the adjacent surface of the implant fixed denture,the occlusal situation of the implant repair area and the looseness degree of the adjacent teeth of the implant fixed denture.Adjacent surface contact relationship includes adjacent surface contact area position,adjacent surface contact area shape,adjacent surface contact tightness and abduction gap size.Occlusal examination includes opposite-jaw filling type cusp,uneven wear,abnormal occlusal contact,mobility of adjacent tooth,etc.proximal contact tightness was measured by metal strip and dental floss.The collected results of oral examination and questionnaire were analyzed by SPSS software.Results: 1.The contact tightness of the adjacent surface of the implant fixed denture was measured by a 0.05-mm-thick metal strip and dental floss respectively.Spearman correlation analysis was performed on the measurement results,and the results showed that the measurement of the metal strip and dental floss are positively correlated(correlation coefficient r=0.866,P< 0.001).2.50 implant fixed dentures had 100 contact surfaces with adjacent natural teeth,of which the incidence of food impaction was 48%(48/100).The tightness of adjacent contact was measured by metal forming sheet.The average tightness of adjacent contact was 0.92 ±0.77 N in food impaction group and 3.68 ±0.55 N in non-food impaction group.The Mann-Whitney U test in the nonparametric test was used for statistical analysis,and the results showed that there was significant difference in adjacent contact tightness between food impaction group and non-food impaction group(Z=-4.750,P<0.001).3.The Pearsonχ2 test was used to statistically analyze the differences in the occurrence of food impaction on gender,age,jaw position,tooth position,and different adjacent surfaces of the denture.The results showed that there was no statistical significance in the differences of food impaction in age,gender and jaw position(P> 0.05).And there were significant differences in the incidence of food impaction in tooth position and adjacent surfaces,with statistical significance(P< 0.05),that is,the incidence of food impaction in the molar area was significantly higher than that in the premolar area,and the incidence of food impaction in the mesial surface was significantly higher than that in the distal surface.4.The influencing factors of food impaction in implant fixed denture were examined by Pearsonχ2 test.Results showed that there was a difference in the incidence of food impaction in adjacent surface contact tightness,abduction gap form,location of adjacent surface contact area,opposite-jaw filling type cusp,abrasion situation,occlusal contact situation and situation of mobility of adjacent tooth,statistically significant(P < 0.05);There was no significant difference in the incidence of food impaction in the adjacent surface contact area shape(P > 0.05).5.Check the results of further related factors for the occurrence of fixed implant food impaction multivariate logistic regression analysis.The results showed that proximal contact tightness and the opposite-jaw filling type cusp were the independent influencing factors of food impaction(P < 0.05).In other words,the proximal contact tightness was a protective factor for the incidence of food impaction(P < 0.001,OR=12.893,95%CI: 4.168-39.886).The tighter the proximal contact was,the less the possibility of food impaction was.The opposite-jaw filling type cusp was a risk factor for food impaction(P<0.05,OR=0.176,95%CI: 0.050-0.632).Conclusion:1.On the basis of excluding other factors affecting food impaction,quantitative measurement of adjacent contact tightness and study of reasonable adjacent contact range can provide important reference significance for personalized design of the adjacent contact relationship of implant fixed denture.2.Adjacent contact tightness is an independent factor affecting whether food impaction occurs in the implant fixed denture.Relatively close adjacent contact can effectively prevent food impaction.In this study,the average proximal contact tightness of the implant fixed denture without food impaction was 3.68±0.55 N,which can be used as a reference for the design of fixed denture,and further study with larger sample size is needed.3.On the dental position and adjacent surface of different dentures,the occurrence of food impaction of implant fixed denture is different,and food impaction is more likely to occur in the molar area than in the premolar area,and food impaction is more likely to occur in the mesial surface than in the distal surface.4.The incidence of food impaction of implant fixed denture is the result of many factors.In addition to the independent influencing factors of the adjacent surface tightness,the abnormal position of adjacent contact and the abnormal size of abduction gap also can affect the incidence of food impaction.However,occlusal conditions can not be ignored,in which the opposite-jaw filling type cusp,uneven wear,loose adjacent teeth,abnormal occlusal contact and other conditions can also affect the occurrence of food impaction. |
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