Kivovics Péter, Jáhn Marianna, Borbély Judit, Márton Krisztina
Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary.
Int J Prosthodont. 2007 Jul-Aug;20(4):397-401.
To determine the location of mucosal injuries that appear following placement of complete dentures, as well as the number of adjustments necessary to achieve patient comfort. The frequency of mucosal injuries in female and male patients and their connection with clinical anatomic features were also investigated.
Sixty-one completely edentulous healthy patients who wore dentures (47 women and 14 men) took part in the study; 122 newly fabricated complete maxillary and mandibular dentures were investigated. All patients were seen for a 1-week adjustment appointment. Areas where signs of denture-induced mucosal injuries appeared were marked on an anatomic illustration. The follow-up period was in 1-week increments as deemed necessary by the patient. Associations between variables were analyzed with analysis of variance. Results were recorded as mean + SD. Statistical significance was set at P < or = .05.
Eighty-seven percent of the dentures required adjustment at week 1, 50% at week 2, and only 7% at week 3. No patients required a further visit. Most frequently injured maxillary areas were the vestibular sulcus (41%), maxillary tuberosity (21%), and hamular notch (12%). In the mandible, the most frequently injured areas were the retromylohyoid area (17%), lingual sulcus (14%), and vestibular sulcus (13%). Denture-induced irritations were detected in a higher ratio in the mandible (P < .001), especially in male denture wearers at the first adjustment (P < .05). Men had a higher ratio of lesions at the region of the maxillary vestibular sulcus between the labial and buccal frenum and at the mandibular vestibular sulcus of the buccal shelf region (P < .001).
Denture-induced irritations appeared most often in the vestibular sulcus of the maxilla and mandible, indicating that it is necessary to evaluate the area of the facial seal of the prosthesis by applying a medium- or a heavy-pressure indicator paste to the borders, and to make adjustments at the delivery stage and subsequent adjustment appointments. Denture placement must not be the final patient-clinician encounter when treating with complete dentures. Denture adjustments are very important clinical phases of denture fabrication and essential in patient care.
确定全口义齿佩戴后出现的黏膜损伤位置，以及达到患者舒适度所需的调整次数。同时研究女性和男性患者黏膜损伤的频率及其与临床解剖特征的关系。
61名佩戴义齿的无牙颌健康患者（47名女性和14名男性）参与了本研究；对122副新制作的上下颌全口义齿进行了研究。所有患者均接受为期1周的调整预约。在解剖图上标记出义齿导致黏膜损伤迹象出现的区域。随访期根据患者需要按1周的增量进行。采用方差分析对变量之间的关联进行分析。结果记录为均值±标准差。设定统计学显著性水平为P≤0.05。
87%的义齿在第1周需要调整，50%在第2周需要调整，第3周仅7%需要调整。没有患者需要进一步复诊。上颌最常受伤的区域是前庭沟（41%）、上颌结节（21%）和翼突切迹（12%）。在下颌，最常受伤的区域是下颌舌骨后区域（17%）、舌沟（14%）和前庭沟（13%）。义齿导致的刺激在下颌中检测到的比例更高（P<0.001），尤其是在初次调整时男性义齿佩戴者中（P<0.05）。男性在上颌前庭沟唇颊系带之间区域以及下颌颊棚区前庭沟处的损伤比例更高（P<0.001）。
义齿导致的刺激最常出现在上颌和下颌的前庭沟，这表明有必要通过在边缘涂抹中压或重压指示剂糊剂来评估义齿面部密封区域，并在交付阶段和后续调整预约时进行调整。在全口义齿治疗中，义齿佩戴并非患者与临床医生的最后接触。义齿调整是义齿制作非常重要的临床阶段，对患者护理至关重要。
