Son Dae-Sik, Seong Jin Wan, Kim Younghoon, Chee Youngjoon, Hwang Chang Ho
Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Ann Rehabil Med. 2013 Apr;37(2):247-53. doi: 10.5535/arm.2013.37.2.247. Epub 2013 Apr 30.
To investigate the relationship between removable dentures and swallowing and describe risks.
Twenty-four patients with removable dentures who were referred for videofluoroscopic swallowing study (VFSS) were enrolled. We evaluated the change of swallowing function using VFSS before and after the removal of the removable denture. The masticatory performance by Kazunori's method, sensation of oral cavity by Christian's method, underlying disease, and National Institutes of Health Stroke Scale for level of consciousness were collected. Functional dysphagia scales, including the oral transit time (OTT), pharyngeal transit time (PTT), percentage of oral residue, percentage of pharyngeal residue, oropharyngeal swallow efficiency (OPSE), and presence of aspiration were measured.
Four patients dropped out and 20 patients were analyzed (stroke, 13 patients; pneumonia, 3 patients; and others, 4 patients). The mean age was 73.3±11.4 years. There were significant differences before and after the removal of the denture for the OTT. OTT was significantly less after the removal of the denture (8.87 vs. 4.38 seconds, p=0.01). OPSE increased remarkably after the removal of the denture, but without significance (18.24%/sec vs. 25.26%/sec, p=0.05). The OTT and OPSE, while donning a removable denture, were correlated with the masticatory performance (OTT, p=0.04; OPSE, p=0.003) and sensation of oral cavity (OTT, p=0.006; OPSE, p=0.007).
A removable denture may have negative effects on swallowing, especially OTT and OPSE. These affects may be caused by impaired sensation of the oral cavity or masticatory performance induced by the removable denture.
探讨可摘局部义齿与吞咽之间的关系并描述相关风险。
招募24名因视频荧光吞咽造影检查(VFSS)而转诊的佩戴可摘局部义齿患者。我们通过VFSS评估了可摘局部义齿摘除前后吞咽功能的变化。收集了用和则法评估的咀嚼性能、用克里斯蒂安法评估的口腔感觉、基础疾病以及用于意识水平评估的美国国立卫生研究院卒中量表。测量了功能性吞咽困难量表,包括口腔通过时间(OTT)、咽部通过时间(PTT)、口腔残留百分比、咽部残留百分比、口咽吞咽效率(OPSE)以及误吸情况。
4名患者退出研究,对20名患者进行了分析(中风患者13名;肺炎患者3名;其他患者4名)。平均年龄为73.3±11.4岁。义齿摘除前后OTT存在显著差异。摘除义齿后OTT显著缩短(8.87秒对4.38秒,p = 0.01)。摘除义齿后OPSE显著提高,但差异无统计学意义(18.24%/秒对25.26%/秒,p = 0.05)。佩戴可摘局部义齿时,OTT和OPSE与咀嚼性能(OTT,p = 0.04;OPSE,p = 0.003)以及口腔感觉(OTT,p = 0.006;OPSE,p = 0.007)相关。
可摘局部义齿可能对吞咽有负面影响,尤其是对OTT和OPSE。这些影响可能是由可摘局部义齿导致的口腔感觉受损或咀嚼性能下降引起的。