Ono Takahiro, Kohda Hideki, Hori Kazuhiro, Nokubi Takashi
Division of Oromaxillofacial Regeneration, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.
Int J Prosthodont. 2007 Mar-Apr;20(2):145-50.
Oral cancer develops frequently in older populations. In Japan, the incidence of oral and pharyngeal cancer is 9,201 per year, with such tumors accounting for 1.74% of all cancers. Although obturator prostheses play an important role in the rehabilitation of postmaxillectomy patients, clinicians sometimes experience difficulty in placing obturator prostheses in edentulous maxillae, and criteria for the objective evaluation of treatment outcome have yet to be established. The present study aimed to investigate postsurgical factors influencing the masticatory performance of postmaxillectomy patients with edentulous maxillae fitted with obturator prostheses.
The extent of the hard palate defect, status of the mandibular dentition, mouth-opening distance, and maximum occlusal force were investigated, and masticatory performance was measured using a testing gummy jelly in 27 postmaxillectomy patients with edentulous maxillae fitted with obturator prostheses. The influence of these items was evaluated quantitatively, and theoretical masticatory performance for each subject was calculated using multiple-regression analysis (quantification method type 1).
Although average masticatory performance was almost equivalent to that of healthy, independent older patients with occlusal support classified as Eichner C, considerable individual variation was noted among subjects. The order of strength of influence on masticatory performance was identified by category weight: extent of hard palate defect > status of posterior mandibular teeth > maximum occlusal force > mouth-opening distance. A relatively high correlation (R2 = 0.78, P < .01, Pearson correlation coefficient) was evident between theoretical and actual values.
Masticatory performance could be predicted by evaluating postsurgical factors in patients with edentulous maxillae fitted with obturator prostheses.
口腔癌在老年人群中高发。在日本，口腔和咽癌的年发病率为9201例，此类肿瘤占所有癌症的1.74%。尽管阻塞器假体在全上颌骨切除术后患者的康复中发挥着重要作用，但临床医生有时在为无牙上颌骨患者放置阻塞器假体时会遇到困难，且治疗效果的客观评估标准尚未确立。本研究旨在调查影响佩戴阻塞器假体的无牙上颌骨全上颌骨切除术后患者咀嚼性能的术后因素。
调查硬腭缺损范围、下颌牙列状况、开口距离和最大咬合力，并使用测试软糖对27例佩戴阻塞器假体的无牙上颌骨全上颌骨切除术后患者的咀嚼性能进行测量。对这些指标的影响进行定量评估，并使用多元回归分析（量化方法1型）计算每个受试者的理论咀嚼性能。
尽管平均咀嚼性能几乎与具有咬合支持的健康、独立的老年Eichner C类患者相当，但受试者之间存在相当大的个体差异。通过类别权重确定对咀嚼性能影响强度的顺序为：硬腭缺损范围＞下颌后牙状况＞最大咬合力＞开口距离。理论值与实际值之间存在较高的相关性（R2 = 0.78，P <.01，Pearson相关系数）。
通过评估佩戴阻塞器假体的无牙上颌骨患者的术后因素，可以预测其咀嚼性能。
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