de Souza Raphael Freitas, Marra Julie, Pero Ana Carolina, Compagnoni Marco Antonio
Department of Dental Materials and Prosthodontics, Ribeirao Preto Dental School, Ribeirao Preto, Sao Paulo, Brazil.
J Prosthet Dent. 2007 Jun;97(6):381-8. doi: 10.1016/S0022-3913(07)60027-4.
The accuracy of assessing maxillomandibular relationships for trial bases and dentures using phonetic and swallowing methods has not been compared to that observed with definitive prostheses. Thus, there is no evidence to prove whether measurements obtained through such methods remain the same after adaptation to dentures.
This study investigated changes in the closest speaking space, interocclusal rest space, and interocclusal distance during deglutition in edentulous patients during and after complete denture treatment.
Eighteen edentulous subjects participated in this study and measurements were performed after 7 intervals of time: (1) with occlusion rims and record bases following creation of the maxillomandibular relationship record, (2) with trial dentures, (3) at insertion of definitive complete dentures, (4) 1 week, (5) 2 weeks, (6) 1 month, and (7) 3 months after insertion. Recordings of interocclusal distances were made with a mandibular kinesiograph. Closest speaking space was measured during the pronunciation of the word 'seis'. The distance between postural rest position and centric occlusion, or interocclusal rest space, was measured using a kinesiograph. Interocclusal distance during deglutition was tested by recording the closest mandibular position recorded during swallowing of 20 mL of water. Data were analyzed using repeated-measure ANOVA, followed by the Student-Newman-Keuls test (alpha=.05).
A significant (P<.01) reduction in the mean closest speaking space was found when it was evaluated using occlusion rims and record bases (4.6 mm) compared with other stages (3.0 to 3.4 mm). No significant differences were found in mean interocclusal rest space and interocclusal distance during deglutition among the time periods evaluated.
The presence of occlusion rims can influence mandibular position during pronunciation of the /s/ sound. The arrangement of artificial teeth changes the closest speaking space. However, rest position and deglutition were not affected, either during denture fabrication or short-term use.
使用语音和吞咽方法评估用于试验基托和义齿的上下颌关系的准确性，尚未与使用最终修复体时观察到的准确性进行比较。因此，没有证据证明通过这些方法获得的测量值在适应义齿后是否保持不变。
本研究调查了无牙颌患者在全口义齿治疗期间和之后吞咽过程中最接近的说话间隙、牙合间休息间隙和牙合间距离的变化。
18名无牙颌受试者参与了本研究，并在7个时间间隔后进行测量：(1) 在确定上下颌关系记录后使用咬合堤和记录基托时；(2) 使用试验义齿时；(3) 最终全口义齿戴入时；(4) 戴入后1周；(5) 戴入后2周；(6) 戴入后1个月；(7) 戴入后3个月。使用下颌运动描记仪记录牙合间距离。在发“seis”这个词时测量最接近的说话间隙。使用运动描记仪测量姿势休息位与正中牙合之间的距离，即牙合间休息间隙。通过记录吞咽20 mL水时记录的下颌最接近位置来测试吞咽过程中的牙合间距离。使用重复测量方差分析进行数据分析，随后进行Student-Newman-Keuls检验（α = 0.05）。
与其他阶段（3.0至3.4 mm）相比，使用咬合堤和记录基托评估时，平均最接近说话间隙显著（P < 0.01）减小（4.6 mm）。在所评估的时间段内，吞咽过程中的平均牙合间休息间隙和牙合间距离没有显著差异。
咬合堤的存在会影响发/s/音时的下颌位置。人工牙的排列改变了最接近的说话间隙。然而，在义齿制作或短期使用期间，休息位和吞咽均未受到影响。
