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一项比较下颌种植体支持覆盖义齿与传统义齿对糖尿病患者疗效的随机临床试验。第五部分:食物偏好比较。

A randomized clinical trial comparing the efficacy of mandibular implant-supported overdentures and conventional dentures in diabetic patients. Part V: food preference comparisons.

作者信息

Roumanas Eleni D, Garrett Neal R, Hamada Michael O, Diener Randy M, Kapur Krishan K

机构信息

Department of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, School of Dentistry, University of California at Los Angeles, 90095-1668, USA.

出版信息

J Prosthet Dent. 2002 Jan;87(1):62-73. doi: 10.1067/mpr.2002.121025.

Abstract

STATEMENT OF PROBLEM

The functional benefits of replacing old dentures with new conventional mandibular dentures or implant-supported overdentures has not been fully determined.

PURPOSE

This study assessed the impact of these 2 types of replacement dentures on the food choices of diabetic patients.

MATERIAL AND METHODS

A total of 68 diabetic patients with original complete dentures participated in this study. Diabetes was controlled with insulin in 38 patients (IT) and without insulin in 30 patients (NIT). All subjects received conventional maxillary dentures; 25 received mandibular conventional dentures (CD), and 43 received overdentures with plastic clips and a Hader bar attached to 2 osseointegrated implants (IOD). Subjects rated their perceptions of taste acceptability, texture acceptability, and chewing ease on a 4-point nominal scale and eating frequency on a 5-point scale for 13 specific foods at baseline (with original dentures) and at 6 months post-treatment completion (PTC). Fisher exact tests were used to compare the change in percentage distributions of responses with treatment. A 2 x 2 x 2 repeated-measures analysis of variance (ANOVA) was performed to compare mean scores between the 2 denture groups, 2 diabetic groups, and 2 time intervals for each of the 13 foods and 4 questions related to food acceptability.

RESULTS

At baseline, no significant differences were found between the frequency distributions of responses in the CD and IOD groups or the IT and NIT groups for all 52 comparisons. With both types of study dentures, a higher percentage of patients perceived deterioration rather than improvement in function. When percentage distributions based on actual positive or negative change (treatment effect) in patient responses were compared, significant differences were found for 3 of the 52 responses, in favor of the IOD group. ANOVA demonstrated significant mean differences for 4 of the 52 comparisons.

CONCLUSION

Both types of study dentures resulted in declines in the perceived taste and texture acceptability of almost all test foods. Declines in perceived chewing ease and eating frequency were more common and greater in the CD than in the IOD group. Both types of study dentures failed to affect food choices, as evidenced by declines or limited improvement in the perceived frequency with which most foods were eaten.

摘要

问题陈述

用新的传统下颌假牙或种植体支持的覆盖义齿替换旧假牙的功能益处尚未完全确定。

目的

本研究评估了这两种类型的替换假牙对糖尿病患者食物选择的影响。

材料与方法

共有68名佩戴原全口假牙的糖尿病患者参与本研究。38名患者(IT组)使用胰岛素控制糖尿病,30名患者(NIT组)未使用胰岛素。所有受试者均佩戴传统上颌假牙;25名患者佩戴下颌传统假牙(CD组),43名患者佩戴附着于2颗骨整合种植体的塑料卡环和Hader杆的覆盖义齿(IOD组)。受试者在基线时(佩戴原假牙)和治疗完成后6个月(PTC),对13种特定食物的味觉可接受性、质地可接受性和咀嚼难易程度进行4分制名义评分,并对进食频率进行5分制评分。采用Fisher精确检验比较治疗后反应百分比分布的变化。进行2×2×2重复测量方差分析(ANOVA),以比较两组假牙、两组糖尿病患者以及13种食物和4个与食物可接受性相关问题在两个时间间隔内的平均得分。

结果

在基线时,CD组和IOD组以及IT组和NIT组在所有52项比较中的反应频率分布均无显著差异。使用两种类型的研究假牙时,更高比例的患者感觉功能恶化而非改善。当比较基于患者反应实际正向或负向变化(治疗效果)的百分比分布时,52项反应中有3项存在显著差异,有利于IOD组。ANOVA显示52项比较中有4项存在显著平均差异。

结论

两种类型的研究假牙均导致几乎所有测试食物的味觉和质地可接受性下降。CD组中咀嚼难易程度和进食频率的下降更为常见且幅度更大,高于IOD组。两种类型的研究假牙均未影响食物选择,这表现为大多数食物的进食频率感知下降或改善有限。

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