Hummel Susan K, Wilson Margaret A, Marker Victoria A, Nunn Martha E
Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas, Texas 75246, USA.
J Prosthet Dent. 2002 Jul;88(1):37-43.
Research-based assessments of the quality of removable partial dentures (RPDs), especially within a large patient population, are lacking.
This study evaluated the prevalence and quality of RPDs by use of the National Health and Nutrition Survey (NHANES III) data set.
Estimates of the health and nutritional status of the American population were obtained from the NHANES III data set (1988-1994). Calibrated dentists performed dental examinations on 17,884 adults. If the subject wore an RPD, its quality was assessed with 5 criteria: integrity, tooth wear, the presence of temporary reline material or adhesive, stability, and retention. In this study, the data on RPD defects were used to assess the prevalence of problems. The original population was divided into 4 subgroups: paired RPD data = subjects wearing both maxillary and mandibular RPDs (n = 600 prostheses, 300 maxillary and 300 mandibular); single RPD data = subjects with only one RPD (n = 1003 prostheses, 511 maxillary and 492 mandibular); maxillary versus mandibular RPD data = all subjects with all RPDs (n = 1603 prostheses, 811 maxillary and 792 mandibular); and pooled RPD data = all subjects with a single RPD plus subjects with 2 RPDs, counting only the RPD with the most defects (n = 1303 prostheses, 674 maxillary and 629 mandibular). The subjects were analyzed with descriptive statistics. The distribution of defects in the RPDs was examined for possible associations with chi(2) tests. The paired data for patients with both maxillary and mandibular RPDs were analyzed with Wilcoxon signed rank tests. The prevalence of RPDs as a function of patient age and the association between RPD defects and patient age were analyzed with chi(2) tests. The results were considered highly significant at P<.0001 and significant at P<.05.
Of the 17,884 adults who underwent a dental examination, 1306 had RPDs. Three patients were excluded because their records were incomplete, leaving 1303 patients available for analysis. Most of the prostheses examined (65%) had at least 1 defect. Lack of stability was the most prevalent single defect. Distinctions in the type and prevalence of defects were observed between mandibular and maxillary RPDs. Mandibular RPDs had significantly more problems related to retention, whereas maxillary RPDs had significantly more problems related to the presence of reline material and to integrity defects. Tooth wear defects were significantly associated with patient age (P<.0001). Only one third of the RPDs were considered satisfactory according to NHANES III criteria.
A review of the database used in this study indicated that, in spite of a decline in tooth loss, RPDs are still used in all age cohorts, including young adults. A large number of RPDs were found to have defects.
目前缺乏基于研究的可摘局部义齿（RPD）质量评估，尤其是在大量患者群体中。
本研究利用美国国家健康与营养调查（NHANES III）数据集评估RPD的患病率及质量。
从NHANES III数据集（1988 - 1994年）获取美国人群健康和营养状况的估计值。经过校准的牙医对17,884名成年人进行了口腔检查。如果受试者佩戴RPD，则根据5项标准评估其质量：完整性、牙齿磨损、临时重衬材料或粘合剂的存在、稳定性和固位。在本研究中，RPD缺陷数据用于评估问题的患病率。原始人群分为4个亚组：配对RPD数据 = 同时佩戴上颌和下颌RPD的受试者（n = 600副义齿，300副上颌和300副下颌）；单RPD数据 = 仅佩戴一副RPD的受试者（n = 1003副义齿，511副上颌和492副下颌）；上颌与下颌RPD数据 = 所有佩戴RPD的受试者（n = 1603副义齿，811副上颌和792副下颌）；汇总RPD数据 = 佩戴一副RPD的所有受试者加上佩戴两副RPD的受试者，仅计算缺陷最多的RPD（n = 1303副义齿，674副上颌和629副下颌）。对受试者进行描述性统计分析。通过卡方检验检查RPD中缺陷的分布，以寻找可能的关联。对同时佩戴上颌和下颌RPD患者的配对数据进行Wilcoxon符号秩检验。通过卡方检验分析RPD患病率与患者年龄的关系以及RPD缺陷与患者年龄的关联。结果在P <.0001时被认为具有高度显著性，在P <.05时具有显著性。
在接受口腔检查的17,884名成年人中，1306人佩戴RPD。3名患者因记录不完整被排除，剩余1303名患者可供分析。大多数检查的义齿（65%）至少有1个缺陷。缺乏稳定性是最常见的单一缺陷。在上颌和下颌RPD之间观察到缺陷类型和患病率的差异。下颌RPD与固位相关的问题明显更多，而上颌RPD与重衬材料的存在和完整性缺陷相关的问题明显更多。牙齿磨损缺陷与患者年龄显著相关（P <.0001）。根据NHANES III标准，只有三分之一的RPD被认为是令人满意的。
对本研究中使用的数据库进行回顾表明，尽管牙齿缺失有所减少，但RPD仍在所有年龄组中使用，包括年轻人。发现大量RPD存在缺陷。
