Kimoto Katsuhiko, Garrett Neal R
Weintraub Center for Reconstructive Biotechnology, School of Dentistry, University of California, Los Angeles 90095-1668, USA.
Int J Oral Maxillofac Implants. 2003 Jul-Aug;18(4):523-30.
This study assessed the impact of mandibular bone height on masticatory performance following treatment with a mandibular conventional denture (CD) or implant-retained overdenture (IOD).
Evaluation of masticatory performance in 63 participants was made with original CDs and 6 months after treatment completion with new dentures; 25 patients received a mandibular CD and 38 received a mandibular IOD. Anterior ridge height at the mandibular symphysis was determined on lateral cephalograms to provide subgroups of low (< or = 21 mm), moderate (> 21 mm, < 28 mm), and high (> or = 28 mm) ridge height for both CDs and IODs. Masticatory performance tests on the preferred chewing side (PS) and swallowing threshold tests were made with peanuts and carrots.
Analysis of variance was used for comparisons of mean change in performance after treatment with study dentures for the 3 bone height groups; this indicated significant differences between the CD and IOD for PS masticatory performance with peanuts (P = .05) and carrots (P = .03). Post hoc tests found significant mean differences between the CDs and IODs with peanuts (P = .008) and carrots (P = .01) only in the low bone height group. Although no significant differences were found in swallowing threshold performance, the mean change scores for subjects with low bone height were greater with the IODs than those with CD for swallowing threshold performance, strokes, and time.
It is suggested that only in patients with advanced ridge resorption is the mandibular IOD more likely than a CD to result in improvements in masticatory performance.
The study indicated that treatment with a mandibular IOD may improve masticatory performance only in persons with a less than adequate mandibular ridge.
本研究评估下颌骨高度对下颌传统义齿（CD）或种植体固位覆盖义齿（IOD）治疗后咀嚼性能的影响。
对63名参与者使用原始CD评估咀嚼性能，并在新义齿治疗完成6个月后进行评估；25名患者接受下颌CD，38名患者接受下颌IOD。通过头颅侧位片确定下颌联合处的前嵴高度，为CD和IOD提供低（≤21mm）、中（>21mm，<28mm）、高（≥28mm）嵴高度亚组。使用花生和胡萝卜对偏好咀嚼侧（PS）进行咀嚼性能测试和吞咽阈值测试。
采用方差分析比较3个骨高度组使用研究义齿治疗后性能的平均变化；这表明在PS咀嚼性能方面，CD和IOD在花生（P = 0.05）和胡萝卜（P = 0.03）测试中有显著差异。事后检验发现，仅在低骨高度组中，CD和IOD在花生（P = 0.008）和胡萝卜（P = 0.01）测试中存在显著平均差异。虽然吞咽阈值性能未发现显著差异，但低骨高度受试者的IOD在吞咽阈值性能、冲程和时间方面的平均变化得分高于CD。
建议仅在牙槽嵴吸收严重的患者中，下颌IOD比CD更有可能改善咀嚼性能。
该研究表明，下颌IOD治疗可能仅在下颌牙槽嵴不足的患者中改善咀嚼性能。
