Armellini Debora B, Heydecke Guido, Witter Dick J, Creugers Nico H J
Department of Restorative Dentistry, Baltimore College of Dental Surgery, University of Maryland, Baltimore, Maryland, USA.
Int J Prosthodont. 2008 Nov-Dec;21(6):524-30.
To assess the value of removable partial dentures (RPDs) in subjects with shortened dental arches (SDAs) with regard to quality of life.
Subjects from 2 university dental centers (82 men, 78 women; mean age: 54 +/- 18 years) were categorized into the following groups: (1) SDA with intact anterior regions (SDA-1, n = 44); (2) SDA and interrupted anterior region (SDA-2, n = 21); (3) SDA (intact anterior region) extended with distal-extension RPD (RPD-1, n = 25); (4) subjects with interrupted SDA and interrupted anterior region treated with RPD (RPD-2, n = 32); or (5) complete dental arches (CDA, n = 38) as a control. All subjects underwent a short clinical examination and completed 2 structured questionnaires: the Oral Health Impact Profile (OHIP-49) and the Short-Form Health Survey (SF-36). Recorded clinical variables included: teeth present (yes/no), replacement by RPD (yes/no), and number of occlusal units. Age-dependent outcomes were adjusted to outcomes for the age of 60 years. Linear regression models were used to assess differences between the groups.
Reliability and validity were good for all subscales. For OHIP, the investigation groups had significantly higher scores (more complaints) than CDA for the subscales "functional limitation," "psychologic discomfort," and "physical disability." Of the 4 investigation groups, SDA-1 subjects had the lowest mean scores. SF-36 scores showed less prominent and less conclusive differences between investigation groups and CDA subjects. SDA-2 subjects showed worse health, with significantly lower scores than RPD-2 subjects for "vitality," "social function," and "mental health." For pure SDA subjects (SDA-1) there was a significant positive effect for "number of occlusal units" in 5 of the OHIP subscales and 2 of the SF-36 subscales.
From a quality-of-life perspective, patients with SDAs perceive benefits from RPDs only if anterior teeth replacements are included. In contrast, in subjects with uninterrupted SDAs, where only posterior teeth were replaced by distal-extension RPDs, such benefits could not be demonstrated.
评估可摘局部义齿（RPD）对牙弓缩短（SDA）患者生活质量的价值。
来自2所大学牙科学院的受试者（82名男性，78名女性；平均年龄：54±18岁）被分为以下几组：（1）前牙区完整的SDA（SDA-1，n = 44）；（2）SDA且前牙区中断（SDA-2，n = 21）；（3）用远中游离RPD扩展的SDA（前牙区完整）（RPD-1，n = 25）；（4）用RPD治疗的SDA中断且前牙区中断的受试者（RPD-2，n = 32）；或（5）全牙弓（CDA，n = 38）作为对照。所有受试者均接受了简短的临床检查，并完成了2份结构化问卷：口腔健康影响程度量表（OHIP-49）和健康调查简表（SF-36）。记录的临床变量包括：现存牙齿（是/否）、RPD修复情况（是/否）以及咬合单位数量。将年龄相关的结果调整为60岁时的结果。采用线性回归模型评估各组之间的差异。
所有子量表的信度和效度均良好。对于OHIP，在“功能受限”“心理不适”和“身体残疾”子量表方面，研究组的得分（抱怨更多）显著高于CDA组。在4个研究组中，SDA-1受试者的平均得分最低。SF-36得分显示研究组与CDA受试者之间的差异不那么显著且不那么具有决定性。SDA-2受试者的健康状况较差，在“活力”“社会功能”和“心理健康”方面的得分显著低于RPD-2受试者。对于单纯的SDA受试者（SDA-1），在OHIP的5个子量表和SF-36的2个子量表中，“咬合单位数量”有显著的正向影响。
从生活质量的角度来看，只有在前牙得到修复的情况下，SDA患者才会从RPD中感知到益处。相比之下，在SDA未中断的受试者中，仅用远中游离RPD修复后牙，并未显示出此类益处。
