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老年无牙颌患者全口义齿佩戴对进食时食团运送的影响。

Impacts of wearing complete dentures on bolus transport during feeding in elderly edentulous.

机构信息

Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, Morioka, Japan.

出版信息

J Oral Rehabil. 2013 Dec;40(12):923-31. doi: 10.1111/joor.12107. Epub 2013 Nov 6.

DOI:10.1111/joor.12107
PMID:24237359
Abstract

Prosthetic treatment with dentures is often required for the elderly who have reduced swallowing function. Therefore, it is important to understand the relationship between denture-wearing and feeding function from the perspective of swallowing. To clarify changes in bolus transport during feeding in elderly edentulous patients with or without complete dentures. Subjects were 15 elderly edentulous volunteers who were treated with maxillary and mandibular complete dentures. The test food was 10 g of minced agar jelly containing barium sulphate with a particle diameter of 4·0-5·6 mm. Lateral videofluoroscopy was performed to assess the position of the leading edge of the bolus, the bolus volume in each area at swallow onset, bolus transit time and the mandibular position during pharyngeal swallowing. There were significant changes between the bolus transport with and without dentures. Without dentures, the leading edge of the bolus at swallow onset fell from the valleculae area to the hypopharynx, and the bolus volume in the hypopharynx increased. Bolus transit time increased in the oral cavity, valleculae and hypopharynx. The mandibular position shifted anterosuperior direction. The results arose owing to anatomical changes in the oral and pharyngeal structure and the following functional changes: poor food manipulation, poor bolus formation and delayed swallowing reflex. Removing dentures in elderly edentulous individuals influences bolus transport during feeding, resulting in the exacerbation of the reduced swallowing reserve capacity that accompanies ageing, and may increase the risk of dysphagia.

摘要

义齿修复常用于吞咽功能下降的老年人。因此,从吞咽的角度了解义齿佩戴与进食功能的关系非常重要。为了阐明有无全口义齿的老年无牙患者在进食过程中食团运送的变化。研究对象为 15 名上颌和下颌均佩戴全口义齿的老年无牙志愿者。测试食物为 10g 含有硫酸钡的颗粒直径为 4.0-5.6mm 的碎琼脂果冻。采用侧位透视法评估食团前缘在吞咽开始时的位置、各区域食团的体积、食团通过时间和咽期下颌的位置。有无义齿时的食团运送有显著变化。无义齿时,食团前缘在吞咽开始时从会厌谷区下降到下咽,下咽区的食团体积增加。口腔、会厌谷和下咽的食团通过时间增加。下颌位置向前上方移位。这些结果源于口腔和咽结构的解剖学变化以及以下功能变化:食物处理不良、食团形成不良和吞咽反射延迟。在老年无牙个体中去除义齿会影响进食时的食团运送,导致与衰老相关的吞咽储备能力下降加剧,并可能增加吞咽困难的风险。

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